Parker v. O'Malley (CONSENT)

IN THE UNITED STATES DISTRICT COURT

FOR THE MIDDLE DISTRICT OF ALABAMA

NORTHERN DIVISION

TAJA PARKER, )

)

Plaintiff, )

)

v. ) Case No. 2:24-cv-007-CWB

)

MARTIN J. O’MALLEY, )

Commissioner of Social Security, )

)

Defendant. )

MEMORANDUM OPINION AND ORDER

I. Introduction and Administrative Proceedings

Taja Parker (“Plaintiff”) filed an application for Disability Insurance Benefits under

Title II of the Social Security Act and an application for Supplemental Security Income under

Title XVI of the Social Security Act on July 29, 2021—alleging disability onset as of

May 28, 2021 due to diabetes and neuropathy. (Tr. 88, 147-48, 157-58).1 The claim was denied

at the initial level on March 30, 2022 and again after reconsideration on September 13, 2022.

(Tr. 88, 147, 155-57, 165-67, 173-75, 186-87). Plaintiff then requested de novo review by an

administrative law judge (“ALJ”). (Tr. 88, 234, 247). The ALJ subsequently heard the case on

April 25, 2023 (Tr. 88, 119-46), at which time testimony was given by Plaintiff (Tr. 122-40) and

by a vocational expert (Tr. 141-45). The ALJ took the matter under advisement and issued a

written decision on June 6, 2023 that found Plaintiff not disabled. (Tr. 88-113).

The ALJ’s written decision contained the following enumerated findings:

1. The claimant meets the insured status requirements of the Social Security Act

through June 30, 2023.

1 References to pages in the transcript are denoted by the abbreviation “Tr.”

2. The claimant has not engaged in substantial gainful activity since May 28, 2021,

the alleged onset date (20 CFR 404.1571 et seq., and 416.971 et seq.).

3. The claimant has the following severe impairments: insulin dependent diabetes

mellitus, hypertension, neuropathy, anemia, depression, anxiety, somatoform

disorder, and substance abuse disorder (marijuana)(not material) (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).

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 she can frequently

push/pull with the upper and lower extremities bilaterally, but never climb

ladders, ropes, and scaffolds or work at unprotected heights or with hazardous

machinery, nor can she engage in any job that requires commercial driving.

She can frequently climb ramps and stairs, as well as occasionally balance, and

she is limited to frequent stooping, kneeling, crouching, and crawling. She can

frequently handle and finger on a bilateral basis. She should avoid concentrated

exposure [to] extreme cold, extreme heat, wetness, and vibration. She can

frequently interact and respond appropriately with supervisors and coworkers

and can frequently do so with customers and members of the general public.

She can respond appropriately to work pressures in the usual work setting and

to changes in a routine work setting if gradually introduced. She can use

judgment in simple work-related decisions. She can understand, remember, and

carry out simple instructions.

6. The claimant is unable to perform any past relevant work (20 CFR 404.1565

and 416.965).

7. The claimant was born on May 25, 2000 (Ex. B2D) and was 21 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 (Ex. B1E) (20 CFR 404.1564

and 416.964).

9. Transferability of job skills is not an issue in this case because the claimant’s

past relevant work is unskilled (20 CFR 404.1568 and 416.968).

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, 404.1569a,

416.969, and 416.969a).

11. The claimant has not been under a disability, as defined in the Social Security

Act, from May 28, 2021, through the date of this decision (20 CFR 404.1520(g)

and 416.920(g)).

(Tr. 90, 91, 92, 96, 111, 112, 113). On November 3, 2023, the Appeals Council denied Plaintiff’s

request for review (Tr. 1-6), thereby rendering the ALJ’s decision the final decision of the

Commissioner. See, e.g., Chester v. Bowen, 792 F.2d 129, 131 (11th Cir. 1986).

Plaintiff now asks the court to reverse the final decision and remand the case for a new

hearing and further consideration. (Doc. 10 at p. 12). As contemplated by 28 U.S.C. § 636(c) and

Rule 73 of the Federal Rules of Civil Procedure, the parties have consented to the exercise of full

jurisdiction by a United States Magistrate Judge (Docs. 6 & 7), and the court finds the case ripe

for review pursuant to 42 U.S.C. §§ 405(g) & 1383(c)(3) in that the court construes Plaintiff’s

supporting brief (Doc. 10) as a motion for summary judgment and the Commissioner’s opposition

brief (Doc. 11) as a competing motion for summary judgment. Upon consideration of the parties’

submissions, the relevant law, and the record as a whole, the court concludes that Plaintiff’s motion

for summary judgment is due to be denied, that the Commissioner’s motion for summary judgment

is due to be granted, and that the final decision is due to be affirmed.

II. Standard of Review and Regulatory Framework

The court’s review of the Commissioner’s decision is a limited one. Assuming the proper

legal standards were applied by the ALJ, the court is required to treat the ALJ’s findings of fact as

conclusive so long as they are supported by substantial evidence. 42 U.S.C. § 405(g); Graham v.

Apfel, 129 F.3d 1420, 1422 (11th Cir. 1997). “Substantial evidence is more than a scintilla,”

but less than a preponderance, “and is such relevant evidence as a reasonable person would accept

as adequate to support a conclusion.” Crawford v. Comm’r of Soc. Sec., 363 F.3d 1155, 1158

(11th Cir. 2004) (“Even if the evidence preponderates against the Commissioner’s findings,

[a reviewing court] must affirm if the decision reached is supported by substantial evidence.”)

(citations omitted). The court thus may reverse the ALJ’s decision only if it is convinced that the

decision was not supported by substantial evidence or that the proper legal standards were not

applied. See Carnes v. Sullivan, 936 F.2d 1215, 1218 (11th Cir. 1991). Reversal is not warranted

simply because the court itself would have reached a contrary result. See Edwards v. Sullivan,

937 F.2d 580, 584 n.3 (11th Cir. 1991). Despite the deferential nature of its review, however, the

court must look beyond those parts of the record that support the decision, must view the record

in its entirety, and must take account of evidence that detracts from the evidence relied on in the

decision. See Hillsman v. Bowen, 804 F.2d 1179, 1180 (11th Cir. 1986); see also Walker v. Bowen,

826 F.2d 996, 999 (11th Cir. 1987).

To qualify for disability benefits and establish entitlement for a period of disability, a

person must be unable 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.

42 U.S.C. § 423(d)(1)(A).2 To make such a determination, the ALJ employs a five-step sequential

evaluation process:

(1) Is the person presently unemployed?

(2) Is the person’s impairment severe?

(3) Does the person’s impairment meet or equal one of the specific impairments set

forth in 20 C.F.R. Pt. 404, Subpt. P, App. 1 [the Listing of Impairments]?

2 A “physical or mental impairment” is one resulting from anatomical, physiological, or

psychological abnormalities that are demonstrable by medically acceptable clinical and laboratory

diagnostic techniques. 42 U.S.C. § 423(d)(3).

(4) Is the person unable to perform his or her former occupation?

(5) Is the person unable to perform any other work within the economy?

An affirmative answer to any of the above questions leads either to the next

question, or, on steps three and five, to a finding of disability. A negative answer

to any question, other than step three, leads to a determination of “not disabled.”

McDaniel v. Bowen, 800 F.2d 1026, 1030 (11th Cir. 1986). See also 20 C.F.R. §§ 404.1520 &

416.920.3

The burden of proof rests on the claimant through step four. See Phillips v. Barnhart, 357

F.3d 1232, 1237-39 (11th Cir. 2004); Ellison v. Barnhart, 355 F.3d 1272, 1276 (11th Cir. 2003).

A claimant establishes a prima facie case of a qualifying disability once he or she has carried the

burden of proof from step one through step four. Id. At step five, the burden shifts to the

Commissioner, who must then show that there are a significant number of jobs in the national

economy that the claimant can perform. Id.

In order to assess the fourth and fifth steps, the ALJ must determine the claimant’s

Residual Functional Capacity (“RFC”). Phillips, 357 F.3d at 1238-39. The RFC is what the

claimant is still able to do despite the claimant’s impairments and is based on all relevant medical

and other evidence. Id. It may contain both exertional and nonexertional limitations. Id. at 1242-

43. At the fifth step, the ALJ considers the claimant’s RFC, age, education, and work experience

to determine if there are jobs available in the national economy that the claimant can perform. Id.

at 1239. To do so, the ALJ can use either the Medical Vocational Guidelines (“grids”), see

3 McDaniel was an SSI case brought under Title XVI. Nonetheless, because the same sequence

applies to claims for disability insurance benefits brought under Title II, cases arising under

Title XVI are appropriately cited as authority in Title II cases, and vice versa. See, e.g., Ware v.

Schweiker, 651 F.2d 408, 412 (5th Cir. 1981); Smith v. Comm’r of Soc. Sec., 486 F. App’x 874,

876 n.* (11th Cir. 2012) (“The definition of disability and the test used to determine whether a

person has a disability is the same for claims seeking disability insurance benefits or supplemental

security income.”).

20 C.F.R. pt. 404 subpt. P, app. 2, or call a vocational expert (“VE”). Id. at 1239-40. The grids

allow the ALJ to consider factors such as age, confinement to sedentary or light work, inability to

speak English, educational deficiencies, and lack of job experience. Each factor can independently

limit the number of jobs realistically available to an individual, and combinations of these factors

yield a statutorily-required finding of “Disabled” or “Not Disabled.” Id. at 1240.

III. Issues on Appeal

Plaintiff raises one issue on appeal: whether the ALJ erred in failing to order a consultative

examination. (Doc. 10 at p. 2).

IV. Discussion

“Social Security proceedings are inquisitorial rather than adversarial,” and “[i]t is the ALJ’s

duty to investigate the facts and develop the arguments both for and against granting benefits.”

Sims v. Apfel, 530 U.S. 103, 110-11 (2000). “Because a hearing before an ALJ is not an adversary

proceeding, the ALJ has a basic obligation to develop a full and fair record.” Graham, 129 F.3d

at 1422.4 “This obligation requires the ALJ to develop the claimant’s complete medical history

for at least the 12 months preceding the month in which the application was filed, assist the

Claimant in obtaining evidence from his or her treating sources, and order a consultative

examination when such an examination is necessary to make an informed decision.” Rivera Perez

v. Comm’r of Soc. Sec., No. 6:20-CV-79, 2021 WL 289052 at *2 (M.D. Fla. Jan. 28, 2021);

20 C.F.R. §§ 404.1512(b)(1)-(2), 416.912(b)(1)-(2).

4 “The basic duty to develop the record rises to a ‘special duty’ where the claimant has not waived

his or her right to representation and is not represented during the administrative proceedings.”

Rivera Perez v. Comm’r of Soc. Sec., No. 6:20-CV-79, 2021 WL 289052 at *2 n.3 (M.D. Fla.

Jan. 28, 2021) (citing Brown v. Shalala, 44 F.3d 931, 934-35 (11th Cir. 1995)) (emphasis added).

Because Plaintiff was represented by counsel at the hearing (Tr. 34-74), the ALJ had only a basic

duty to develop the record.

The ALJ’s obligation to develop the record “exists even if the claimant is represented by

counsel or has waived the right to representation.” Cowart v. Schweiker, 662 F.2d 731, 735

(11th Cir. 1981) (citations omitted). However, “[t]here must be a showing that the ALJ’s failure

to develop the record led to evidentiary gaps in the record, which resulted in unfairness or clear

prejudice, before the court will remand a case for further development of the record.” Rodriguez-

Torres v. Saul, No. 8:18-CV-1982, 2019 WL 4267955 at *4 (M.D. Fla. Sept. 10, 2019), aff’d sub

nom. Torres v. Comm’r of Soc. Sec., 819 F. App’x 886 (11th Cir. 2020). “At a minimum, clear

prejudice ‘requires a showing that the ALJ did not have all of the relevant evidence before him in

the record ... or that the ALJ did not consider all of the evidence in the record in reaching his

decision.’” Rivera Perez, 2021 WL 289052 at *3 (quoting Kelly v. Heckler, 761 F.2d 1538, 1540

(11th Cir. 1985)); Thomas-Joseph v. Comm’r of Soc. Sec., No. 21-11020, 2022 WL 1769134 at *2

(11th Cir. June 1, 2022).

Plaintiff argues that the ALJ erred in failing to order a consultative medical examination

because the medical record pertaining to her “diabetes related impairments, especially diabetic

neuropathy, presented an extensive, complex and ambiguous record, such that a consultative

examination was necessary for the ALJ to properly determine the nature and extent of [her]

physical symptoms and limitations and their impact on [her] RFC.” (Doc. 10 at pp. 11-12).

Plaintiff asserts that there were no consultative medical examinations in the record for the ALJ

to consider and that the exhibits in the record did not provide the ALJ with sufficient,

unambiguous, and adequate evidence to make an informed decision. (See id. at p. 12). The

Commissioner contends that the ALJ did not need to obtain a consultative examination because

the record already contained sufficient evidence for the ALJ to make a determination that Plaintiff

was not disabled. (See Doc. 11 at p. 4).

The evidence before the ALJ indeed was sufficient for the ALJ to properly assess Plaintiff’s

disability claim. In addition to Plaintiff’s testimony, the ALJ also considered function reports,

treatment records, and State agency medical consultants’ prior administrative medical findings.

The record reflects that the ALJ thoroughly considered Plaintiff’s diabetes related impairments,

including diabetic neuropathy. The ALJ found that the medical record “repeatedly” documented

that Plaintiff’s hospitalizations for diabetic ketoacidosis were due to medication noncompliance

and that she responded “quickly” to treatment with insulin during her hospitalizations. (Tr. 91,

2151-52, 2209, 2317, 2496, 2526, 2536, 2546, 2553, 2734-35, 2742-43, 2745, 2748, 2750, 2752).

The ALJ discussed the treatment records at length as follows:

Around the time of the May 25, 2021 alleged onset date, the claimant presented to

Baptist Medical Center South for complaints of arm and leg pain on May 28, 2021,

she was found to be in diabetic ketoacidosis and admitted, and she reported

experiencing stress from school and work (Ex. B3F at 184). The claimant did

“very well” with treatment for diabetic ketoacidosis, Neurontin (gabapentin)

helped her arm and leg pain, and she was discharged on May 30, 2021 after her

diabetic ketoacidosis resolved with treatment (Ex. B3F at 184). Upon the

claimant’s discharge, Jun Yoo, D.O. continued the claimant on gabapentin for

diabetic peripheral neuropathy, thought that the claimant would “do very

well” on an insulin pump, and advised her to follow up with outpatient

endocrinology for a possible insulin pump (Ex. B3F at 184).

The claimant visited Montgomery Family Medicine on July 20, 2021 and

reported that she was not checking her glucose regularly and denied weight

loss, fatigue, blurred vision, polydipsia, polyuria, and nocturia (Ex. B2F at 30). The

claimant also reported stinging pain in her legs but did not want to increase her

dosage of gabapentin (Ex. B2F at 30). The claimant was alert, oriented, and in no

acute distress, she had normal sensation, strength, coordination, and reflexes,

and her thought content and affect appeared normal (Ex. B2F at 31).

The claimant was admitted to Baptist Medical Center South intensive care unit on

July 27, 2021 for treatment of uncontrolled type 1 diabetes with diabetic

ketoacidosis and after she ran out of medication and presented with complaints of

nausea and vomiting (Ex. B3F at 100-101, 103). The claimant stabilized with

treatment, she developed some side effects due to a high dose of Cymbalta and

this was lowered to 30 mg, which the claimant tolerated well, she remained

stable with acceptable blood sugar, compliance was discussed with the

claimant, and she was discharged on July 31, 2021 (Ex. B3F at 100-101). In

addition, a July 29, 2021 echocardiogram showed a left ventricular ejection fraction

of 55 to 60 percent (Ex. B17F at 21).

The claimant was admitted to Baptist Medical Center South intensive care unit for

treatment of diabetic ketoacidosis again on August 23, 2021 after she reported

smoking marijuana all weekend and waking up feeling disoriented and unwell with

nausea and vomiting (Exs. B4F at 8, 73-74, B6F at 149). The claimant’s diabetic

ketoacidosis resolved with treatment, and she was transferred to the floor and

was alert, awake, and oriented upon examination with no edema of her extremities

(Exs. B4F at 73-74, B6F at 149). ...

On September 14, 2021, the claimant was readmitted to Baptist Medical Center

South after she presented to the emergency room with persistent nausea and

vomiting and was found to have diabetic ketoacidosis (Ex. B2F at 47-48). The

claimant had “not been taking any of her medications” and reported that she

“decided to discontinue all of her medications” and had not taken insulin in

three days (Ex. B6F at 81-82). The claimant’s diabetic ketoacidosis resolved

with treatment, she was moved to the floor and placed on sliding scale insulin,

and gastroenterology recommended considering whether her nausea and

vomiting was secondary to her regular marijuana use rather than diabetic

ketoacidosis and did not recommend any interventions (Ex. B2F at 48). The

claimant was counseled about stopping marijuana and taking all her medications,

and she was discharged on September 17, 2021 (Ex. B2F at 46-48). However, the

claimant was readmitted on September 25, 2021 for treatment of diabetic

ketoacidosis, which resolved with treatment, she was educated on medication

compliance, checking her blood glucose level, keeping a log, and following the

directions on her insulin regimen upon her discharge on September 30, 2021, and

she was advised to follow up with primary care and endocrinology (Ex. B2F at

123). The claimant was alert, oriented, cooperative, and in no acute distress with

normal range of motion, normal strength, no tenderness, no swelling, normal

motor function, no focal neurological deficits, and an appropriate mood and

affect upon her discharge (Ex. B6F at 11-12).

When the claimant was readmitted to Baptist Medical Center South for treatment

of diabetic ketoacidosis on October 14, 2021, which resolved with treatment,

Maria Azeem, M.D. spoke with the claimant’s mother, who noted that the claimant

had Lantus and sliding scale insulin at home and was “able to afford it as well”

(Ex. B7F at 8). Dr. Azeem gave the claimant all the instructions for her medication

regimen upon her discharge on October 17, 2021 (Ex. B7F at 8). Dr. Azeem also

prescribed metoprolol, hydralazine, and labetalol for hypertension (Ex. B7F at 8).

The claimant was alert, oriented, cooperative, and in no acute distress with clear

lungs, a normal cardiovascular rate, a soft and nontender abdomen, normal range

of motion, and an appropriate mood and affect upon her discharge (Ex. B7F at 8-

9). The claimant was readmitted on October 28, 2021 after she presented not feeling

well, lethargic, and nauseated (Ex. B9F at 5-6). The claimant was found to have

diabetic ketoacidosis and started treatment with intravenous insulin and

fluids, her blood sugar improved, she was switched to Lantus, she remained

clinically stable, her mental status returned to normal, and she was discharged

on November 2, 2021 (Ex. B8F at 5-6).

About one month later, the claimant presented to Baptist Medical Center South

again … on December 2, 2021 with symptoms of nausea and pain all over, was

admitted to for treatment of diabetic ketoacidosis, and “quickly responded” to

treatment with intravenous insulin and fluids (Ex. B10F at 9). The claimant was

switched to Lantus insulin and transferred to the regular floor, and she remained

clinically stable (Ex. B10F at 9). Discharge notes indicated that the claimant was

also using marijuana, counseling was given, including to take insulin and other

medications regularly, the claimant verbalized understanding, and she was

discharged home on December 4, 2021 (Ex. B10F at 9). The claimant’s discharge

diagnoses were diabetic ketoacidosis, noncompliance, diabetic neuropathy,

and multiple previous hospital admissions for diabetic ketoacidosis from

noncompliance (Ex. B10F at 8).

...

The claimant was readmitted to Baptist Medical Center South on April 16, 2022

after she presented to the emergency room with complaints of fatigue and dizziness

and reported that she had not been taking her Lantus over the past two days because

she ran out (Ex. B12F at 4). The claimant was assessed with diabetic ketoacidosis

“secondary to not taking medications” (Ex. B12F at 8) and started on intravenous

fluids and an insulin drip (Ex. B12F at 4). The claimant’s diabetic ketoacidosis

resolved with treatment. Neetha Vadde, M.D. discussed medication assistance

for the claimant with case management, and the claimant was discharged on

April 19, 2022 (Ex. B12F at 18, 23-24).

On April 29, 2022, the claimant visited Baptist Health Physician Group to establish

care with a primary care provider. The claimant reported that she was “only

randomly checking” her blood sugar instead of with meals or any other

specific times (Ex. B14F at 37). The claimant also reported experiencing

neuropathy pain in her legs and feet and reported that Lyrica helped if she took two

(Ex. B14F at 37). Upon examination, the claimant’s range of motion and strength

were grossly normal with no joint swelling, her sensory and motor findings

were grossly normal, and she was alert, oriented, and cooperative with an

appropriate mood and affect and normal judgment (Ex. B14F at 38). Savannah

Giovane, M.D. advised the claimant to return to a carb ratio and continue Lantus,

advised a diabetic diet, and advised her to follow up with endocrinology (Ex. B14F

at 38). Dr. Giovane also noted that the claimant insisted on a neurology referral for

electrodiagnostic testing, and she provided this referral and refilled Lyrica

(Ex. B14F at 38). The claimant also admitted to occasional cannabis use, and

Dr. Giovane advised the claimant that she must discontinue cannabis for Lyrica to

be prescribed, which the claimant agreed to do (Ex. B14F at 38).

The claimant visited Montgomery Family Medicine Residency Program on

May 19, 2022 for a follow up visit for suture removal following Nexplanon

insertion and reported that she was feeling well and denied any fever or “other

significant symptoms” (Ex. B23F at 61). The claimant was alert, oriented, and in

no acute distress with grossly normal range of motion and strength, no joint

swelling, grossly normal sensory and motor findings, an appropriate mood and

affect, and normal judgment (Ex. B23F at 62).

On May 23, 2022, the claimant visited Baptist Health Neurological Clinic for

evaluation of complaints of burning, numbness, and tingling in her bilateral legs

(Ex. B22F at 22). The claimant reported that she did not have constant pain in her

feet and instead occasionally had shooting pain in her feet (Ex. B22F at 22). The

claimant was alert, oriented, pleasant, calm, cooperative, and dressed appropriately

on examination, and she had a stable gait, intact muscle strength and tone, intact

deep tendon reflexes, intact vibratory and pinprick sensation and negative

straight leg raising, and she had no swelling or edema in any extremity

(Ex. B22F at 23). The claimant did not appear overly anxious or depressed, her

thought processes appeared intact and well organized, her memory was good, and

she answered questions appropriately and correctly (Ex. B22F at 23). Kellie Bagi,

C.R.N.P. started the claimant on amitriptyline for her lower extremity paresthesia,

advised the claimant to maintain tight glucose control for her diabetes, and ordered

imaging and electrodiagnostic testing (Ex. B22F at 23-24). A June 2022 MRI of

the claimant’s brain showed no significant intracranial abnormality (Ex. B20F at

47).

The claimant visited UAB Medicine Endocrinology & Diabetes on June 6, 2022

for follow up regarding her diabetes (Ex. B25F at 19). Vaishali Thudi, M.D. noted

that the claimant had last been seen in January 2021 and had since had multiple

admissions for diabetic ketoacidosis (Ex. B25F at 19). The claimant admitted to

drinking high sugar drinks and not checking her blood glucose consistently,

and the claimant reported that she was “able to afford the libre 2” continuous

glucose monitor and was planning to pay out of pocket (Ex. B25F at 19). The

claimant was alert and oriented with no focal neurological deficits and a normal

gait, and she had a normal mood and affect (Ex. B25F at 20). Dr. Thudi noted that

the claimant’s A1C level had improved from 14 to 11.5, noted that her goal was

below 6.5 without hypoglycemia, and noted that the claimant continued to be

noncompliant with glucose checks and correction boluses and continued to

show “dietary indiscretion” (Ex. B25F at 20). Dr. Thudi had a long discission

about the claimant about the importance of maintaining glycemic control,

reinforced that she needed to stay compliant with boluses, and adjusted her

medication regimen (Ex. B25F at 21).

The claimant subsequently presented to the Baptist Medical Center South

emergency room on June 29, 2022 with complaints of nausea, vomiting,

lightheadedness, and lethargy (Ex. B20F at 45). The claimant reported that she had

been out of Lantus for three days, she was started on an insulin drip and diabetic

ketoacidosis protocol, and she was switched to non-intravenous insulin after

she improved (Ex. B20F at 45). The claimant’s other medical problems were stable

without any further intervention during her admission (Ex. B20F at 45). The

claimant reported that she had difficulty paying for her insulin, case

management was involved for a medication voucher, versions of insulin that

were available at a lower cost were prescribed, the claimant was discharged on

July 1, 2022, and she was advised to follow up with primary care and endocrinology

(Ex. B20F at 41, 45). Upon her discharge, the claimant was alert, oriented,

cooperative, and in no acute distress with normal range of motion, normal

strength, and normal motor function (Ex. B20F at 46).

On July 13, 2022, electrodiagnostic testing showed mild to moderate distal

symmetric length-dependent sensorimotor polyneuropathy that was primarily

axonal (Ex. B22F at 20-21). When the claimant followed up at Baptist Health

Neurological Clinic on July 25, 2022, she reported that she ran out of Lyrica since

her last visit (Ex. B22F at 17). Nurse Bagi assessed the claimant with mild to

moderate polyneuropathy consistent with diabetes, restarted her on Lyrica,

increased her dosage of amitriptyline, and advised the claimant to take her

medication as prescribed for pain (Ex. B22F at 18). Nurse Bagi also advised the

claimant to continue to follow up with primary care and endocrinology for her

diabetes (Ex. B22F at 18).

The claimant subsequently followed up with Dr. Thudi on July 26, 2022 and

reported that she was non-compliant with insulin and dealing with stress in

her personal life (Ex. B25F at 15). The claimant had a normal gait, normal range

of motion, and no focal central nervous system deficits as well as a normal mood

and affect (Ex. B25F at 16). Dr. Thudi noted that the claimant’s A1C level had

worsened to 12.5 and noted that while the claimant was “well aware” of her current

insulin regimen, she admitted to being “very noncompliant” (Ex. B25F at 16).

Dr. Thudi had a lengthy discussion with the claimant about the importance of

glycemic control and noted that the claimant’s last admission for diabetic

ketoacidosis was from running out of insulin (Ex. B25F at 17).

On August 6, 2022, the claimant presented to Baptist Medical Center South with

nausea and vomiting, was found to have diabetic ketoacidosis, was started on a

diabetic ketoacidosis protocol with an insulin drip until her anion gap closed, was

transferred to Lantus insulin and sliding scale insulin, progressed well with

treatment, was eating and drinking adequately, and was discharged on August 8,

2022 (Ex. B20F at 21).

The claimant followed up with Dr. Thudi on September 27, 2022 (Ex. B25F at 12).

The claimant’s hemoglobin A1C level was 13.7, and Dr. Thudi noted that the

claimant did not bring her logbook or glucometer and did not take her insulin

regularly (Ex. B25F at 12). Dr. Thudi noted that the claimant’s diabetes was

poorly controlled due to poor compliance and referred her for help form [sic]

social services to help obtain her insulin (Ex. B25F at 13).

The claimant visited Montgomery Family Medicine Residency Program on

October 10, 2022 for complaints related to tonsilitis and denied any nausea,

vomiting, fever, or diarrhea (Ex. B23F at 52). The claimant was alert, oriented, and

in no acute distress with normal range of motion and strength, no swelling, an

appropriate mood and affect, and normal judgment (Ex. B23F at 53).

The claimant also followed up at Baptist Health Neurological Clinic on

October 25, 2022 and reported that her neuropathy had worsened, but she reported

that she had not filled her prescription for Lyrica, and she denied any side

effects from amitriptyline (Ex. B22F at 14). The claimant also reported that her

diabetes was improving (Ex. B22F at 14). Though the claimant’s mother

reported that the claimant needed assistance with stairs, the claimant’s gait

was stable upon examination, her muscle tone and strength were intact, her

deep tendon reflexes were intact and symmetric, and she had no clubbing or

cyanosis of her extremities (Ex. B22F at 15). Nurse Bagi restarted the claimant

on Lyrica and advised her to contact their office if she had any issues obtaining

this medication (Ex. B22F at 15). The claimant was also interested in physical

therapy, and Nurse Bagi referred her for physical therapy (Ex. B22F at 15).

The claimant subsequently presented to Baptist Medical Center South on

November 28, 2022 with complaints of nausea, vomiting, weakness, and shortness

of breath starting three days previously and reported that she had not been taking

her insulin, and her risk factors included noncompliance (Ex. B15F at 1, 76).

The claimant’s hemoglobin A1C level was 12.7 on her admission, and progress

notes indicated that she had “questionable compliance” with her home

medications (Ex. B15F at 18). Though the claimant reported compliance with

insulin, treatment notes indicated that she had “not picked up any since July

2022 from pharmacies she provided” (Ex. B15F at 20). The claimant also had

medications with her that had apparently not been refrigerated (Ex. B15F at

20). On admission, the claimant was found to be hyperglycemic, acidotic, and

leukocytotic (Ex. B15F at 77). The claimant received treatment with a diabetic

ketoacidosis protocol (Ex. B15F at 6), her diabetic ketoacidosis resolved, she was

transitioned to sliding scale insulin with oral intake, and her blood sugar remained

controlled with this treatment (Ex. B15F at 58, 77). The claimant also attended a

physical therapy initial evaluation during her hospitalization on November 29, 2022

and had a rolling walker during the visit (Ex. B15F at 52-53). However, treatment

notes indicated that the claimant presented with good seated balance, her

strength and range of motion were within functional limits, she was able to

ambulate 200 feet without physical assistance and did not require use of an

assistive device to do this, she demonstrated “good balance with steady pace,”

and she was discharged from physical therapy “due to no acute mobility needs

at this time” (Ex. B15F at 53). The claimant continued to tolerate ambulation

after her discharge from physical therapy (Ex. B15F at 61), she was discharged

on December 2, 2022 (Ex. B15F at 1, 77), and discharge notes indicated that she

continued to “ambulate on her own without issue” upon her discharge

(Ex. B15F at 68). Refills of her insulin were sent to the Baptist Tower to be

obtained through the Tower of Hope program (Ex. B15F at 77). The claimant

was instructed to keep a blood sugar log to bring to her follow up appointments so

it could be reviewed and changes could be made to her insulin regimen if needed

(Ex. B15F at 77).

The claimant followed up with Dr. Thudi on December 27, 2022 (Ex. B25F at 10).

Dr. Thudi noted that the claimant continued to “stay noncompliant” with insulin

injections, admitted to being busy at work and not checking her blood sugars

or doing carb counts, and had not reached out to her social worker to get

additional support (Ex. B25F at 10). Dr. Thudi adjusted the claimant’s medication

regimen, provided paperwork for patient assistance for insulin and diabetic

supplies, and had a lengthy discussion with the claimant about the complications

of uncontrolled diabetes (Ex. B25F at 11).

The claimant subsequently presented to the Baptist Medical Center South

emergency room on January 6, 2023 with complaints of vomiting for one day and

being thirsty for two days, and the claimant was lethargic and noncommunicative

on examination (Ex. B16F at 34-35). In the emergency room, the claimant’s blood

sugar level was 615 with a high acetone level and three plus glucose in urine

analysis, she received treatment for diabetic ketoacidosis with intravenous insulin

and fluids, her anion gap closed twice, and she was successfully transitioned to

Lantus and sliding scale insulin (Ex. B16F at 35). The claimant remained stable

throughout her admission, she tolerated her diet and improved to the point that she

was stable for discharge on January 8, 2023, and she was advised to take her

medication, log her blood sugar, and bring her blood sugar log to her follow up

appointment with her primary care provider (Ex. B16F at 35).

On January 13, 2023, the claimant attended a session of outpatient physical

therapy, and she walked into the clinic without an assistive device (Ex. B17F at

1-2). When the claimant returned on January 18, 2023, she reported that she did not

feel well, started to slump, was assisted to supine, and was taken to the emergency

room (Ex. B17F at 6), where she was admitted and received treatment with

intravenous fluids and insulin per diabetic ketoacidosis protocol (Ex. B17F at 22).

The claimant’s hemoglobin A1C level was more than 12 percent, which Mine

Tawadrous, D.O. noted suggested “poor adherence,” Dr. Tawadrous discussed

follow up with primary care and endocrinology (Ex. B17F at 79), and the claimant

was discharged on January 22, 2023 (Ex. B17F at 16, 22).

...

The claimant was readmitted on February 7, 2023 for treatment of diabetic

ketoacidosis “likely due to medication noncompliance,” she was started on

ferrous sulfate three times a week for iron deficiency anemia, she was discharged

on February 10, 2023 after she improved with treatment, and she was advised to

restart her home medication of Lyrica for diabetic neuropathy (Ex. B19F at 34-35,

37, 44, 54). A transthoracic echocardiogram also showed a left ventricular ejection

fraction of 65 to 70 percent (Ex. B19F at 2). Nicole Davis, M.D. also reached out

to a care advisor during the claimant’s hospitalization for assistance with

obtaining insulin for the claimant until she was able to complete documents

for a patient assistance program (Ex. B19F at 44).

On February 14, 2023, the claimant followed up with Dr. Thudi and reported that

her blood sugars had improved recently as she had cut down her carbs and

was taking her medication (Ex. B25F at 6-7). Dr. Thudi observed that the claimant

was alert and oriented with a normal mood and affect, no focal central nervous

system deficits, normal range of motion, and a normal gait, and she adjusted the

claimant’s medications (Ex. B25F at 6-7).

On February 17, 2023, the claimant visited the Montgomery Family Medicine

Residency Program and reported that she had adjusted her diet and stopped

snacking throughout the day, she was using a continuous glucose monitor, and

she had been doing a “much better job” with her blood glucose level, including

checking it (Ex. B23F at 25). The claimant also reported that she had been eating

breakfast every day and had been waking up in a “much better mood in general”

(Ex. B23F at 25). The claimant requested a prescription for a rollator walker and

reported easy fatigue while doing errands (Ex. B23F at 25). The claimant was alert

and in no acute distress with normal range of motion, normal strength, and no

edema, and she was cooperative with an appropriate mood and affect (Ex. B23F at

26). Patricia Hughes, D.O. praised the claimant for her “increase in medical

compliance” and change in diet, noted that the claimant’s diabetes was

improved, and advised her to follow up with endocrinology and continue her “path

to better blood glucose control, lower A1C, and better health” (Ex. B23F at 26).

Dr. Hughes also noted that the claimant’s reports of fatigue were also likely due

to physical deconditioning, prescribed a rollator walker, and referred her to

physical therapy (Ex. B2F at 27).

When the claimant followed up at Baptist Health Neurological Clinic on

March 27, 2023, she reported some improvement in her neuropathy since her

last visit, reported that her diabetes had improved, which lessened the severity

of her pain, and denied any side effects from Lyrica or amitriptyline (Ex. B22F

at 1). The claimant’s gait was stable upon examination, her muscle tone and

strength were intact, her deep tendon reflexes were intact and symmetric, and

she had no clubbing or cyanosis of her extremities (Ex. B22F at 2). Nurse Bagi

increased the claimant’s dosage of amitriptyline, continued her on Lyrica, and

advised her that continued improvement in her diabetic control would likely

also improve her diabetic neuropathy (Ex. B22F at 2).

The claimant returned to Montgomery Family Medicine Residency Program on

March 29, 2023 and reported that she was doing well for the most part with some

continued blood sugar control issues (Ex. B23F at 7). The claimant was alert,

oriented, and in no acute distress with normal range of motion, normal strength,

no swelling, and appropriate mood and affect, and normal judgment upon

examination (Ex. B23F at 8). The claimant attended a physical therapy outpatient

evaluation on April 10, 2023, reported feeling easily fatigue[d] with light output,

arrived with a four-wheel walker, and was “upbeat” and “eager to get started”

(Ex. B24F at 1-2).

On April 13, 2023, the claimant followed up with Dr. Thudi at UAB Medicine

Endocrinology & Diabetes for outpatient follow up regarding her diabetes

(Ex. B25F at 1). Dr. Thudi noted that the claimant had been sleeping during the

daytime and staying awake overnight, she had been eating high carbohydrates

at night and missing boluses of insulin, and she was not compliant with

monitoring her home blood glucose level (Ex. B25F at 1). The claimant

admitted to being noncompliant with her correction and carb boluses of

insulin and reported that she was constantly snacking without doing any

Humalog boluses (Ex. B25F at 2). Dr. Thudi had a lengthy discussion about the

importance of glycemic control with the claimant and recommended glucose

checks before each meal and bedtime, provided medication samples, and adjusted

the claimant’s medications (Ex. B25F at 2-3).

(Tr. 97-105) (emphasis added).

The ALJ then determined that the record as a whole did not support Plaintiff’s allegations

of disabling symptoms and limitations:

Regarding her diabetes, the medical record repeatedly documents that the

claimant’s hospitalizations for diabetic ketoacidosis were due to medication

noncompliance (Exs. B10F at 8, B12F at 8, B15F at 18, B17F at 79, B19F at 24,

34, 44, 51, B25F at 1-2, 9-10, 12, 15, 17, 19), and the claimant responded “quickly”

(Ex. B10F at 9) to treatment with insulin during her hospitalizations. Though the

claimant testified that she was not compliant with her medication because she could

not afford it, this is not entirely consistent with the record overall, which documents

that the claimant remained noncompliant with her diabetes medication despite the

availability of and receiving help with obtaining her medications through patient

assistance programs, and she remained noncompliant with her diabetes medications

as well as other aspects of her diabetic treatment plan, including noncompliance

with a diabetic diet and as well as with checking and recording her blood glucose

level as directed. In July 2021, the claimant reported that she was not checking her

glucose regularly (Ex. B2F at 30). In September 2021, the claimant had “not been

taking any of her medications” and reported that she “decided to discontinue all of

her medications” (Ex. B6F at 81-82). The claimant’s mother noted that the claimant

was able to afford her insulin in October 2021 (Ex. B7F at 8). In April 2022,

Dr. Vadde discussed medication assistance for the claimant with case management

(Ex. B12F at 18, 23-24), and when the claimant established care with a primary

care provider in April 2022, the claimant reported that she was “only randomly

checking” her blood sugar instead of with meals or any other specific times as

directed (Ex. B14F at 37). When the claimant visited outpatient endocrinology for

the first time within the relevant period in June 2022, over a year after the alleged

onset date, the claimant admitted to drinking high sugar drinks and not checking

her blood glucose consistently, reported that she was “able to afford” a continuous

glucose monitor, and did not report difficulty affording her medication, and

Dr. Thudi noted that the claimant continued to be noncompliant with glucose

checks and correction insulin boluses and continued to show “dietary indiscretion”

(Ex. B25F at 19-20). When the claimant reported that she had difficulty paying for

her insulin later in June 2022, case management was involved for a medication

voucher and versions of insulin that were available at a lower cost were prescribed

(Ex. B20F at 41, 45). When the claimant followed up with her endocrinologist in

July 2022, the claimant admitted to being “very noncompliant” and cited stress in

her personal life rather than difficulty affording her medication (Ex. B25F at 15-

16). The claimant did not bring her logbook or glucometer and reported that she did

not take her insulin regularly when she followed up with Dr. Thudi in September

2022, and Dr. Thudi assessed her with poor compliance and referred her for

help form [sic] social services to help obtain her insulin (Ex. B25F at 12-13).

Though the claimant subsequently reported compliance with insulin during her

November 28, 2022 hospitalization to treat diabetic ketoacidosis, treatment notes

indicated that she had not picked up her medication since July 2022 (Ex. B15F at

20), and refills of her insulin were sent to the Baptist Tower to be obtained through

the Tower of Hope program (Ex. B15F at 77). However, even after receiving this

additional medication assistance, when the claimant followed up with Dr. Thudi on

December 27, 2022, Dr. Thudi noted that the claimant continued to “stay

noncompliant” with insulin injections, admitted to being busy at work and not

checking her blood sugars or doing carb counts, and had not reached out to her

social worker to get additional support with obtaining her medications, and

Dr. Thudi provided the claimant with paperwork for patient assistance for insulin

and diabetic supplies (Ex. B25F at 10-11). Over a month later, Dr. Davis also

reached out to a care advisor in February 2023 for assistance with obtaining insulin

for the claimant until she completed documents for a patient assistance program

(Ex. B19F at 44). When the claimant reported later in February 2023 that she had

cut down her carbs and was taking her medication, she also reported that her blood

sugars had improved (Ex. B25F at 6-7). The claimant also reported to Dr. Hughes

that she had adjusted her diet and stopped snacking throughout the day, she was

using a continuous glucose monitor, and she had been doing a “much better job”

with her blood glucose level, including checking it, and Dr. Hughes noted that the

claimant’s diabetes had improved with this increase in compliance with her

treatment plan (Ex. B23F at 25). However, the claimant remained noncompliant in

her most recent visit with outpatient endocrinology in April 2023 and admitted that

she had been eating high carbohydrates, she was “constantly snacking” without

doing any Humalog boluses, and she was not compliant with monitoring her home

blood glucose level as directed (Ex. B25F at 1-2). The claimant’s exacerbations in

her diabetes appear to be based upon noncompliance with her medication as well

as with noncompliance with other aspects of treatment plan documented over the

course of the relevant period despite assistance with obtaining her medications, and

the medical record shows that her diabetes responded favorably to increases in

compliance with her diabetes treatment plan recommended by her endocrinologist

and primary care provider (Ex. B23F at 25, 25F at 1-2).

Regarding her diabetic neuropathy, electrodiagnostic testing showed neuropathy in

the mild to moderate range (Ex. B22F at 20-21), and the claimant reported that

Lyrica was helpful for treating her neuropathy (Ex. B14F at 37), though she also

reported at times that she was not taking her prescription for Lyrica (Ex. B22F at

14, 17-18) and was advised to contact her neurologist for assistance if she had any

issues obtaining this medication (Ex. B22F at 15). The claimant reported

improvement in her diabetic neuropathy with improvement in her diabetic control

with increased compliance in March 2023 and denied side effects from Lyrica or

amitriptyline (Ex. B22F at 1-2). The claimant was also advised in recent treatment

notes that continued improvement in her diabetic control would likely also improve

her diabetic neuropathy (Ex. B22F at 2). In addition, the medical record does not

support the conclusion that a walker was medically necessary or expected to be

medically necessary for 12 consecutive months. The claimant regularly exhibited

normal strength, tone, range of motion, reflexes, coordination, and gait over the

course of the relevant period (Exs. B22F at 2, 15, 23, B25F at 6-7, 16, 20) as well

as intact vibratory and pinprick sensation on neurological exam (Ex. B22F at 23).

Though the claimant had a rolling walker[,] a physical therapy initial evaluation

during her November 29, 2022 hospitalization, on examination, her strength and

range of motion were within functional limits, she was able to ambulate 200 feet

without physical assistance and did not require use of an assistive device to do this,

she demonstrated “good balance with steady pace,” and she was discharged from

physical therapy “due to no acute mobility needs at this time” (Ex. B15F at 52-53).

The claimant continued to tolerate ambulation after her discharge from physical

therapy (Ex. B15F at 61), and hospital discharge notes indicated that she continued

to “ambulate on her own without issue” upon her discharge (Ex. B15F at 68). On

January 13, 2023, the claimant attended a session of outpatient physical therapy,

and she walked into the clinic without an assistive device (Ex. B17F at 1-2). While

the claimant requested a prescription for a rollator walker from her primary care

provider on February 17, 2023 and received one, she did not exhibit an unstable or

unsteady gait and had normal strength and range of motion, no focal neurological

deficits, and no edema on examination (Ex. B23F at 25-27), which does not support

the conclusion that this prescription was expected to be medically necessary for 12

consecutive months, and she had a normal gait with no focal neurological deficits

three days earlier on February 14, 2023 (Ex. B25F at 6). On March 27, 2023, the

claimant’s gait was stable upon examination, her muscle tone and strength were

intact, her deep tendon reflexes were intact and symmetric, and she had no clubbing

or cyanosis of her extremities (Ex. B22F at 2). The claimant also had normal range

of motion, normal strength, and no swelling upon examination on March 29, 2023

(Ex. B23F at 8). Therefore, the undersigned finds that a walker was not medically

necessary for 12 consecutive months and is not expected to be medically necessary

for 12 consecutive months. The claimant also received routine treatment for her

hypertension and anemia over the course of the relevant period (Exs. B7F at 8,

B18F at 2, B19F at 44, 51, B23F at 48), and the medical record does not support

the conclusion that these conditions caused disabling functional limitations that

lasted or were expected to last for 12 consecutive months. Furthermore, though the

claimant testified to debilitating medication side effects, the medical record does

not document this extent of medication side effects lasting or expected to last for

12 consecutive months. Though the claimant developed some side effects due to a

high dose of Cymbalta in July 2021, her dosage was lowered to 30 mg, which the

claimant tolerated well (Ex. B3F at 100-101). The claimant subsequently denied

side effects from amitriptyline in October 2022 (Ex. B22F at 14) and from Lyrica

or amitriptyline in March 2023 (Ex. B22F at 1) and testified that her side effects

from her heart medication improved after her dosage of heart mediation was

adjusted.

(Tr. 105-07).

As to Plaintiff’s argument that the ALJ failed to develop the record by not obtaining a

consultative medical examination, the ALJ was under no duty to do so. An ALJ “is not required

to order a consultative examination as long as the record contains sufficient evidence for the

administrative law judge to make an informed decision.” Ingram v. Comm’r of Soc. Sec. Admin.,

496 F.3d 1253, 1269 (11th Cir. 2007); Castle v. Colvin, 557 F. App’x 849, 853 (11th Cir. 2014)

(“The ALJ ‘has a duty to develop the record where appropriate but is not required to order a

consultative examination as long as the record contains sufficient evidence for the [ALJ] to make

an informed decision.’”) (citation omitted). The “[o]rdering [of] a consultative examination is

a discretionary matter for the ALJ and would be sought ‘to try to resolve an inconsistency

in the evidence or when the evidence as a whole is insufficient to support a determination

or decision’ on the claim.” Banks for Hunter v. Comm’r, Soc. Sec. Admin., 686 F. App’x 706,

713 (11th Cir. 2017) (citation omitted); 20 C.F.R §§ 404.1519a(b), 416.919a(b) (“We may

purchase a consultative examination to try to resolve an inconsistency in the evidence, or when the

evidence as a whole is insufficient to allow us to make a determination or decision on your

claim.”). As shown above, the ALJ had sufficient evidence to assess Plaintiff’s claims and

determine her RFC, and Plaintiff has failed to show that there were any evidentiary gaps in

the record resulting in unfairness or clear prejudice. A consultative examination thus was

not necessary. See Gentle v. Kijakazi, No. 8:21-CV-2900, 2023 WL 2446609 at *4 (M.D. Fla.

Mar. 10, 2023) (“[T]he mere lack of a consultative examination is inadequate to meet a plaintiff's

burden to demonstrate prejudice. ... Rather, a plaintiff must show the ALJ’s decision would

have been impacted by a consultative examination.”) (citations omitted); Schrimpsher v. Kijikazi,

No. 4:21-CV-472, 2022 WL 16924102 at *3 (N.D. Ala. Nov. 14, 2022) (“[Plaintiff] hasn’t pointed

to any evidentiary gaps in the record, and he was represented during the administrative process,

so he had a duty to produce evidence related to his disability. Plus, [Plaintiff] can only speculate

that a consultative exam ... would provide evidence that supported his claim of disability.

Speculation isn’t a basis for an ALJ to order a consultative exam.”) (internal citation omitted).

To the extent Plaintiff suggests that the ALJ needed to order a consultative examination

because she had diabetes, she fails to cite any authority showing that the presence of a particular

condition or impairment requires an ALJ to order a consultative examination. Here, the record as

a whole is neither incomplete nor inadequate. Instead, the record was sufficient for the ALJ to

evaluate Plaintiff’s impairments and functional ability, and it does not contain the kind of gaps

required to demonstrate prejudice. As reflected by the ALJ’s extensive discussion of the record,

the ALJ did not need to seek a consultative examination to reach an informed decision. See

Kever v. O’Malley, No. 2:23-CV-626, 2024 WL 2239738 at *3 (M.D. Ala. May 17, 2024) (“It

is [the plaintiff’s] burden to show that she is disabled, and her mere speculation that a

consultative examination would have shown that she is more limited than her RFC is not sufficient

to remand her disability application to the Commissioner.”); Slocumb v. Comm’r of Soc. Sec.,

No. 5:16-CV-617, 2017 WL 2889804 at *4 (M.D. Fla. May 15, 2017) (“[T]he only purported

prejudice that Plaintiff points to in her brief is the lack of a consultative psychological examination

.. but it is Plaintiff's duty to show how the ALJ’s failure to obtain a psychological examination

prejudiced her[.] [T]he mere lack of a consultative examination is inadequate to meet Plaintiff’s

burden when the record contains sufficient evidence to determine whether she is disabled.”)

(emphasis in original). Accordingly, considering the record as a whole, the court finds that the

ALJ’s disability determination was supported by substantial evidence.

V. Conclusion

After carefully and independently reviewing the record, and for the reasons stated above,

the court concludes as follows:

e that Plaintiffs motion for summary judgment (Doc. 10) is due to be DENIED;

e that the Commissioner’s motion for summary judgment (Doc. 11) is due to be

GRANTED; and

e that the Commissioner’s decision is due to be AFFIRMED.

A separate judgment will issue.

DONE this the 18th day of July 2024. a /

IAW

CHAD W. BRYAN

UNITED STATES MAGISTRATE JUDGE

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