Edna Napier v. Comm'r of Soc. Sec.

RECOMMENDED FOR PUBLICATION

Pursuant to Sixth Circuit I.O.P. 32.1(b)

File Name: 25a0027p.06

UNITED STATES COURT OF APPEALS

FOR THE SIXTH CIRCUIT

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EDNA K. NAPIER,

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Plaintiff-Appellant, │

> No. 24-5494

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v. │

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COMMISSIONER OF SOCIAL SECURITY, │

Defendant-Appellee. │

┘

Appeal from the United States District Court for the Eastern District of Kentucky at Lexington.

No. 5:22-cv-00318—David L. Bunning, District Judge.

Decided and Filed: February 7, 2025

Before: BATCHELDER, BUSH, and BLOOMEKATZ, Circuit Judges.

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COUNSEL

ON BRIEF: Caeden Sehested, Julie Atkins, OLINSKY LAW GROUP, Syracuse, New York,

for Appellant. Frank D. Tankard, SOCIAL SECURITY ADMINISTRATION, Baltimore,

Maryland, Charles P. Wisdom, Jr., Cheryl Morgan, UNITED STATES ATTORNEY’S OFFICE,

Lexington, Kentucky, for Appellee.

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OPINION

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BLOOMEKATZ, Circuit Judge. After the Social Security Administration denied her

application for disability insurance benefits, Edna Napier challenged that decision in district

court. She argued that the administrative law judge (ALJ) erred in denying her benefits by

finding that her mental impairments were mild, rather than severe, and by failing to account for

those mental impairments in assessing her residual functional capacity. The district court

No. 24-5494 Napier v. Comm’r of Soc. Sec. Page 2

affirmed. Because the ALJ complied with the applicable procedures and his findings were

supported by substantial evidence, we affirm.

BACKGROUND

Edna Napier worked as a cashier at a grocery store from 2000 to 2006 and as a certified

nursing assistant at an adult day care facility from 2007 to 2016. In 2016, Napier found herself

unable to work because she was in severe pain caused by several physical conditions and was

suffering from depression and anxiety.

Napier filed for disability insurance benefits. In 2018, the Social Security Administration

denied Napier’s application. In a hearing decision, an ALJ found that although Napier had

severe physical impairments, including degenerative disc disease, osteoarthritis, and obesity, she

was not disabled because she could still perform her past work as a cashier.

In December 2019, Napier filed a new application for disability insurance benefits and

supplemental security income. She stated in her application that she had been unable to work

since December 2018 because of several physical conditions, including degenerative disc

disease, severe osteoarthritis, migraines, severe leg pain, and asthma, along with mental

conditions including depression and anxiety.

After holding an evidentiary hearing, an ALJ issued a written decision concluding that

Napier was not disabled under the Social Security Act. See 42 U.S.C. §§ 416(i), 423(d). To

arrive at that determination, the ALJ performed the Social Security Act’s required “five-step

sequential evaluation process” for adjudicating claims of disability. See 20 C.F.R.

§ 404.1520(a)(4); see also Heston v. Comm’r of Soc. Sec., 245 F.3d 528, 534 (6th Cir. 2001).

The claimant bears the burden of proof at each of the first four steps in that process; the burden

shifts to the Commissioner only at step five. Walters v. Comm’r of Soc. Sec., 127 F.3d 525, 529

(6th Cir. 1997). If the ALJ finds at any of the five steps that the claimant is not disabled, the ALJ

denies the claim. See Barnhart v. Thomas, 540 U.S. 20, 24 (2003).

At the first step, the ALJ determines whether the claimant is engaged in “substantial

gainful activity”—in other words, working—at the time they apply for disability benefits.

No. 24-5494 Napier v. Comm’r of Soc. Sec. Page 3

20 C.F.R. § 404.1520(a)(4)(i). If the claimant is, the ALJ will find that they are not disabled. Id.

At the second step, the ALJ considers whether the claimant has a “severe” impairment—that is,

an impairment that “significantly limits” the claimant’s “physical or mental ability to do basic

work activities.” Id. § 404.1520(a)(4)(ii), (c). The ALJ will find that a claimant is not disabled

unless the claimant can show such an impairment. Id. At step three, if the claimant has an

impairment that is on the Commissioner’s list of impairments presumed to be severe enough to

warrant a finding of disability, the ALJ will find the claimant disabled without any need for

further inquiry. Id. § 404.1520(a)(4)(iii); see also Barnhart, 540 U.S. at 24–25. At step four, the

ALJ examines a claimant’s “residual functional capacity”—the claimant’s ability to work,

despite their limitations—and their “past relevant work.” 20 C.F.R. § 404.1520(a)(4)(iv). If the

ALJ determines that the claimant is still capable of doing their past relevant work,

notwithstanding their limitations, the ALJ will find that the claimant is not disabled. Id.

Finally, if the ALJ has determined that the claimant is not capable of resuming their past relevant

work, the ALJ must find the claimant disabled unless the Commissioner can demonstrate

that the claimant can resume “other work” that is available in the national economy. Id.

§ 404.1520(a)(4)(v); see also Heston, 245 F.3d at 534.

Here, the ALJ found that Napier was not disabled at step four.

Step 1. At step one, the ALJ found that Napier had not engaged in substantial gainful

activity since December 2018, the date at which Napier stated that she became disabled.

20 C.F.R. § 404.1520(a)(4)(i).

Step 2. At step two, the ALJ found that three of Napier’s physical conditions—

degenerative disc disease, osteoarthritis, and obesity—qualified as severe impairments. Id.

§ 404.1520(a)(4)(ii). The ALJ also found that Napier’s mental impairments—anxiety and

depression—did not qualify as severe. The ALJ evaluated the severity of Napier’s mental

impairments in accordance with 20 C.F.R. § 404.1520a, which requires an ALJ to rate the degree

to which a claimant’s impairments limit their ability to function in “four broad functional

areas”—(1) “[u]nderstand, remember, or apply information”; (2) “interact with others”;

(3) “concentrate, persist, or maintain pace”; and (4) “adapt or manage oneself.” Id.

§ 404.1520a(c)(3); see also Beaty v. Comm’r of Soc. Sec., No. 19-6310, 2020 WL 6821061, at *3

No. 24-5494 Napier v. Comm’r of Soc. Sec. Page 4

(6th Cir. Sept. 17, 2020). The ALJ found that Napier had “no limitations” in interacting with

others and “no more than mild limitations” with respect to the other three broad functional areas.

ALJ Decision, R. 8, PageID 45–46. As part of this determination, the ALJ considered the

opinions of several psychologists who had examined Napier.

Before turning to step three, the ALJ noted that the “residual functional capacity

assessment” laid out later in step four of his decision “reflect[ed] the degree of limitation” that

the ALJ “ha[d] found in the . . . mental function analysis.” Id. at PageID 48.

Step 3. At step three, the ALJ stated that Napier’s severe physical limitations did not

meet or equal the severity of one of the impairments listed at 20 C.F.R. Part 404, which would

have meant Napier qualified as disabled without the need for any further analysis. See

20 C.F.R.§ 404.1520(a)(4)(iii). So the ALJ proceeded to the fourth step.

Step 4. At the fourth step, see id. § 404.1520(a)(4)(iv), the ALJ concluded that Napier

retained the “residual functional capacity” to perform her past relevant work as a cashier, ALJ

Decision, R. 8, PageID 49, 61. He accordingly found that Napier was not disabled under the

Social Security Act. The ALJ noted that in arriving at this determination, he had “considered all

symptoms.” Id. at PageID 49. Because the ALJ found that Napier was not disabled at step four,

he rejected her application and did not proceed to step five.

Napier challenged the ALJ’s decision in federal district court, arguing that the ALJ

erroneously concluded that Napier’s mental impairments were not severe and failed to explain

how those mental impairments played into his residual functional capacity analysis. The district

court affirmed the ALJ’s decision, and Napier timely appealed.

ANALYSIS

Our review of the ALJ’s decision is “limited to determining whether it is supported by

substantial evidence and was made pursuant to proper legal standards.” Rogers v. Comm’r of

Soc. Sec., 486 F.3d 234, 241 (6th Cir. 2007). Substantial evidence is “more than a scintilla of

evidence but less than a preponderance,” id. (citation omitted); it is “such relevant evidence as a

reasonable mind might accept as adequate to support a conclusion,” Biestek v. Berryhill,

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587 U.S. 97, 103 (2019) (citation omitted). Even when an ALJ’s decision is supported by

substantial evidence, we will reverse the decision if we find that the ALJ failed to follow the

applicable procedural regulations. Miller v. Comm’r of Soc. Sec., 811 F.3d 825, 833 (6th Cir.

2016).

On appeal, Napier challenges the ALJ’s treatment of only her mental impairments. She

argues that the ALJ violated applicable procedural regulations and that the ALJ’s decision was

unsupported by substantial evidence. Napier’s challenges are unpersuasive.

I. Severity of Napier’s Mental Impairments

Napier argues that the ALJ erred in concluding at step two that her mental impairments

were not severe. We disagree.

Substantial evidence supports the ALJ’s determination that Napier’s mental impairments

were not severe. First, as the ALJ noted, when Napier was directly asked by her attorney which

of her “main symptoms” were causing her to be “unable to work,” Napier pointed only to her

physical symptoms and did not mention her depression or anxiety. Hearing Tr., R. 8, PageID 78.

From this testimony, the ALJ appears to have reasonably inferred that Napier did not consider

herself to be severely affected by her mental impairments. Second, the ALJ emphasized that

Napier’s treatment history with respect to her anxiety and depression was quite limited; although

Napier testified that she had been prescribed antidepressants by a medical (not mental)

healthcare provider, Napier had had no history of inpatient or outpatient mental health

treatment.1 And finally, the ALJ carefully outlined the findings of several psychologists who

examined Napier, including Dr. Stiles, Dr. Whitehead, and Dr. Palmer, and explained why those

findings demonstrated that Napier’s mental impairments were not severe. The ALJ noted, for

example, that the evidence showed that Napier’s mental impairments could be controlled using

medication. We think this evidence is sufficient that a “reasonable mind might accept” it as

“adequate to support” the ALJ’s conclusion that Napier’s mental impairments were not severe.

Biestek, 587 U.S. at 103 (citation omitted).

1

Napier argues that the ALJ erred in relying on her lack of mental health treatment, explaining that she

could not afford treatment because of her “financial constraints.” Appellant Br. at 12. But Napier does not point to

any evidence in the record demonstrating those financial constraints.

No. 24-5494 Napier v. Comm’r of Soc. Sec. Page 6

Napier’s arguments do not persuade us that the ALJ’s conclusion was unsupported by

substantial evidence or that the ALJ violated applicable regulations. Napier first contends that

the ALJ erred in relying on her ability to perform everyday activities like reading and paying

bills to conclude that her mental impairments caused her “no more than mild” limitations. She

emphasizes that the applicable regulations require the ALJ to determine the extent to which a

claimant’s mental impairments affect the claimant’s ability to function on a “sustained basis.”

20 C.F.R. § 404.1520a(c)(2) (emphasis added). In Napier’s view, her personal activities—which

she characterizes as “sporadic”—do not shed light on what work she can perform on a sustained

basis. Appellant Br. at 11.

The ALJ, however, did not rely heavily on Napier’s ability to perform these activities in

determining whether her mental impairments affected her ability to function on a sustained basis.

True enough, in prior cases we have explained that an ALJ may not rely on a claimant’s

“household and social activities” to find that a claimant’s mental impairments are not severe

unless the ALJ can “establish” that the claimant can perform those activities on a “sustained

basis.” Miller, 811 F.3d at 838. But we have found this kind of reliance on a claimant’s daily

and sporadic activities to be problematic only when the ALJ relied too heavily on those activities

to conclude that a claimant’s mental impairments were not severe, notwithstanding contrary

record evidence. In Gayheart v. Commissioner of Social Security, for example, we concluded

that an ALJ’s focus on “isolated pieces of the record”—specifically, the claimant’s ability to visit

family members and go grocery shopping—was an “insufficient basis for” according “little

weight” to the record evidence suggesting that the claimant’s mental impairments were severe.

710 F.3d 365, 377–78 (6th Cir. 2013); see also Miller, 811 F.3d at 838 (holding that an ALJ’s

reliance on the claimant’s “household and social activities” was an “insufficient basis to

determine” that the claimant “could conduct work activities on a sustained basis”).

The ALJ did not make such an error here. The ALJ carefully analyzed the entirety of the

record evidence regarding Napier’s ability to function, using Napier’s statements regarding her

activities only as one factor among many. As we have noted, the ALJ first carefully reviewed

the medical evidence regarding Napier’s mental impairments and explained that it appeared that

those impairments were not severe and could be controlled with medication. Turning to the

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extent to which Napier was limited in the “four broad functional areas” that ALJs must assess,

see 20 C.F.R. § 404.1520a(c)(3), the ALJ then evaluated Napier’s claims regarding her

functional limitations, using Napier’s everyday activities as one way to evaluate the credibility of

her assertions. With respect to Napier’s ability to concentrate, for example, see id., the ALJ

noted that although Napier claimed that she had difficulty concentrating, she also stated that she

reads daily. And the record also demonstrated that Napier had never shown an “inability to

complete testing that assesses concentration and attention.” ALJ Decision, R. 8, PageID 46.

This is not a case, in other words, where substantial record evidence pointed towards the

claimant having a severe impairment, and the ALJ nonetheless chose to ignore that evidence and

conclude that the claimant’s impairment was not severe based on the claimant’s ability to do

sporadic everyday activities. See Gayheart, 710 F.3d at 377–78; Miller, 811 F.3d at 838. Here,

considering that substantial other record evidence indicated that Napier’s mental impairments

were not severe, the ALJ did not err in including evidence regarding the activities Napier could

perform in its analysis.

Next, Napier argues that the ALJ failed to follow the applicable regulations when

evaluating the opinion of Dr. Larry Palmer, a psychologist who examined Napier and opined that

she had certain moderate (not mild) mental limitations. Those regulations require an ALJ to

“articulate” how “persuasive” the ALJ finds “all of the medical opinions.” 20 C.F.R.

§ 404.1520c(b). In determining the persuasiveness of a medical opinion, the ALJ is required to

consider several factors, including “[s]upportability”—that is, how a medical opinion comports

with the objective medical evidence in the record. Id. § 404.1520c(c)(1). Napier contends that

the ALJ violated these requirements both by failing to address why Dr. Palmer’s opinion was

less persuasive than the opinions of two other psychologists, Dr. Jennifer Stiles and Dr. Robert

Paul—who opined that Napier had only mild limitations—and by failing to assess the

supportability factor with respect to Dr. Palmer’s testimony.

Napier’s assertions that the ALJ failed to follow the required procedures for assessing

medical opinions are belied by the record. The ALJ explicitly noted that Dr. Palmer’s opinion

was less persuasive than the opinions of Dr. Stiles and Dr. Paul because the latter doctors’

findings were “consistent with and supported by,” among other things, the fact that Napier had

No. 24-5494 Napier v. Comm’r of Soc. Sec. Page 8

no history of inpatient or outpatient mental health treatment. ALJ Decision, R. 8, PageID 47.

And in the same paragraph regarding the persuasiveness of the medical opinions in the record,

the ALJ elaborated that certain aspects of Dr. Palmer’s opinion appeared to be “internally

unsupported” by other findings in the record. Id. The ALJ, in other words, explicitly explained

why it found Dr. Palmer’s medical opinion less persuasive than others and addressed the

supportability factor. See 20 C.F.R. § 404.1520c(c)(1).

Finally, Napier argues that the ALJ’s conclusions regarding Napier’s mental impairments

were erroneous because the ALJ mischaracterized Dr. Palmer’s findings. Napier argues that in

stating that Napier’s medical examination findings were “relatively benign,” the ALJ ignored

some of Dr. Palmer’s findings, including that Napier was estimated “to be functioning in the

borderline range of general intelligence” and had a history of suicidal thoughts. We do not read

the ALJ to have impermissibly mischaracterized Dr. Palmer’s report. Although the ALJ did not

list out each of Dr. Palmer’s individual remarks about Napier’s symptoms, he summarized

Dr. Palmer’s report, explicitly recognized Dr. Palmer’s belief that Napier had more than mild

limitations, and explained why Dr. Palmer’s findings were less persuasive than the findings of

other doctors who examined Napier. And, as we have already noted, substantial evidence

supports the ALJ’s finding that Napier had no more than mild mental limitations. We may not

reweigh those findings. Rather, as long as the ALJ’s findings were, as here, supported by

substantial evidence, we may not second-guess them, even if substantial evidence would support

the opposite conclusion. See Ulman v. Comm’r of Soc. Sec., 693 F.3d 709, 714 (6th Cir. 2012).

We hold that the ALJ’s conclusion that Napier’s mental impairments were not severe was

procedurally proper and supported by substantial evidence.

II. Residual Functional Capacity Analysis

Napier argues that the ALJ’s residual functional capacity analysis violated applicable

regulations requiring the ALJ to consider “all of [the claimant’s] medically determinable

impairments” of which the ALJ is aware, “including [the claimant’s] medically determinable

impairments that are not ‘severe.’” See 20 C.F.R. § 404.1545(a)(2) (citation omitted).

Napier contends that the ALJ inappropriately ignored her mild, non-severe mental impairments

No. 24-5494 Napier v. Comm’r of Soc. Sec. Page 9

in formulating her residual functional capacity and determining that she could perform light

work.

The record clearly demonstrates that the ALJ adequately accounted for Napier’s mental

impairments in formulating her residual functional capacity. In explaining the required five-step

process for addressing Napier’s application, the ALJ noted that in determining Napier’s residual

functional capacity, he was required to “consider all of the claimant’s impairments, including

impairments that are not severe.” ALJ Decision, R. 8, PageID 43. After concluding that

Napier’s mental impairments were no more than mild, the ALJ explicitly stated that his “residual

functional capacity assessment used at steps 4 and 5” later in his decision reflected the “degree of

limitation” that the ALJ had found in the “mental function analysis.” Id. at PageID 48. And the

ALJ later noted that in concluding that Napier had the “residual functional capacity to perform

light work,” he had “considered all symptoms.” Id. at PageID 49. We have previously reasoned

that, depending on the context, similar statements can be sufficient to demonstrate that the ALJ

adequately considered all of a claimant’s medical impairments in formulating a residual

functional capacity analysis. See Emard v. Comm’r of Soc. Sec., 953 F.3d 844, 851 (6th Cir.

2020). Though there may be occasions where, in context, similar statements would be

insufficient, this is not such a case. Considering the substantial evidence supporting the ALJ’s

findings that Napier’s limitations were no more than mild and the ALJ’s repeated statements that

it took all of Napier’s limitations into account, we hold that the ALJ adequately accounted for

Napier’s limitations in the residual functional capacity analysis.

CONCLUSION

We affirm the district court’s judgment.