Murray v. Commissioner of Social Security

IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF OHIO

Constance Murray, Case No. 5:24cv00639

Plaintiff,

-vs- JUDGE PAMELA A. BARKER

Magistrate Judge Amanda Knapp

Frank Bisignano,

Commissioner of Social

Security MEMORANDUM OPINION AND

ORDER

Defendants.

This matter is before the Court on the Objections of Plaintiff Constance Murray (“Plaintiff”

or “Murray”) to the Report and Recommendation of Magistrate Judge Amanda Knapp regarding

Plaintiff's request for judicial review of Defendant Commissioner of the Social Security

Administration's (“Defendant” or “Commissioner”) denial of her application for Disability Insurance

Benefits (“DIB”) under Title II of the Social Security Act. (Doc. No. 12.) For the following reasons,

Plaintiff's Objections (Doc. No. 12) are overruled, the Report & Recommendation (“R&R”) (Doc.

No. 11) is accepted as set forth herein, and the Commissioner's decision is affirmed.

I. Procedural History

In January 2022, Murray filed her application for DIB, alleging a disability onset date of

August 13, 2021. (Doc. No. 6 (Transcript [“Tr.”] ) at 18.) The application was denied initially and

upon reconsideration, and Murray requested a hearing before an administrative law judge (“ALJ”).

(Id.) On May 2, 2023, the ALJ conducted a telephone hearing at which Murray was represented by

counsel and testified. (Id.) See also Tr. 33-51. A vocational expert (“VE”) also testified. (Id.)

On May 18, 2023, the ALJ found that Murray was not disabled. (Tr. 18-28.) The ALJ

determined that Murray suffered from the severe impairments of anxiety and post-traumatic stress

disorder (“PTSD”). (Tr. 20.) The ALJ found that Murray’s impairments did not meet or medically

equal the requirements of a listed impairment and that she retained the residual functional capacity

(“RFC”) to perform a full range of work at all exertional levels but with the following non-exertional

limitations: routine tasks with detailed but uninvolved instructions, no contact with the public,

occasional interactions with coworkers, occasional interactions with supervisors, and occasional

changes in work processes or tasks. (Tr. 21-26.) The ALJ then concluded that Murray could not

perform her past relevant work as a corrections officer, but could perform other jobs that existed in

significant numbers in the national economy and, therefore, was not disabled. (Tr. 26-28.) The

Appeals Council declined to review the ALJ's decision, and the ALJ's decision became the

Commissioner's final decision. (Tr. 1-3.)

Plaintiff seeks judicial review pursuant to 42 U.S.C. §§ 405(g) and 1383(c). (Doc. No. 1.)

The case was referred to the Magistrate Judge pursuant to 28 U.S.C. § 636 and Local Rule 72.2(b)(1)

for a Report and Recommendation (“R&R”). In the R&R, the Magistrate Judge concludes that the

ALJ’s decision is supported by substantial evidence and recommends that the decision be affirmed.

(Doc. No. 11.) On April 1, 2025, Plaintiff filed the following Objections to the R&R:

I. The Magistrate Judge erred in finding that the ALJ properly articulated the

supportability factor when evaluating the medical opinions of the state agency

psychological consultants.

II. The Magistrate Judge erred in finding that the ALJ properly articulated the

persuasiveness of the medical opinion of Anne Greenberg, M.D.

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(Doc. No. 12.) The Commissioner filed a Response on April 14, 2025. (Doc. No. 13.) The Court

has conducted a de novo review of the issues raised in Plaintiff’s Objections.

II. Evidence

A. Personal and Vocational Evidence

Murray was born in December 1970 and was 52 years-old at the time of her administrative

hearing (Tr. 26, 33, 65), making her a “person closely approaching advanced age” under Social

Security regulations.1 20 C.F.R. §§ 404.1563(d). She has a high school education, completed two

years of college, and is able to communicate in English. (Tr. 26, 190.) She has past relevant work

as a corrections officer. (Tr. 26.)

B. Relevant Medical Evidence2

The record reflects that Murray attended appointments with her primary care provider, Larry

Kramer, D.O., in November and December 2021. (Tr. 484-486, 491-493, 498-499.) She reported

sleep disturbance, anxiety, and rapid heart rate/palpitations. (Id.) Upon examination, Dr. Kramer

noted a blood pressure of 120/90 and a BMI of 36.00. (Tr. 492-493.) Dr. Kramer also noted that

Murray was alert, had a normal mood/affect, normal range of motion, and normal heartbeat rhythm.

(Id.) He diagnosed Murray with anxiety/depression and “symptoms of rapid heartbeat,” prescribed

Melatonin, and referred her for an electrocardiogram (“ECG”) and mental health evaluation. (Tr.

1 The regulations provide as follows: “Person closely approaching advanced age. If you are closely approaching advanced

age (age 50–54), we will consider that your age along with a severe impairment(s) and limited work experience may

seriously affect your ability to adjust to other work.” 20 C.F.R. § 404.1563(d).

2 The Court’s recitation of the medical evidence is not intended to be exhaustive and is limited to the evidence that is

necessary to resolution of the instant Objections.

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486, 492-493.) The record reflects Murray underwent an ECG in December 2021, which she reported

was negative. (Tr. 498.)

On December 16, 2021, Murray attended an initial mental health assessment with therapist

Sandra Elliott. (Tr. 471-80.) Murray complained of stress, anxiety, and insomnia. (Tr. 471.) Her

reported symptoms included rapid heartbeat, fear, panic, sweaty palms, thinking that “something is

going wrong,” excessive worrying, obsessions/compulsions, and difficulty falling asleep. (Tr. 471,

474.) Murray reported that these problems began after she witnessed a prison riot in July 2021 during

which the inmates said they planned to rape the female guards. (Tr. 471.) Murray’s mental status

examination was normal, with a cooperative and friendly attitude, full range of mood/affect, normal

speech, logical thought processes, fair insight, and intact judgment. (Tr. 478-479.) Ms. Elliot

recommended that Murray attend weekly therapy sessions, medication management with Steven

Levinson, M.D., and a psychological evaluation. (Id.)

On January 10, 2022, Murray attended a psychiatric evaluation via video with Dr. Levinson.

(Tr. 454-62.) Murray told Dr. Levinson about her traumatic experience at work in July 2021, when

she was working as a corrections officer. (Tr. 454.) She stated that, after this incident, she became

anxious and jittery.3 (Id.) Murray complained of anxiety, stress, and poor sleep. (Tr. 454-456.) She

reported symptoms of irritability, less interest in activities, avoidance of driving over bridges,

discomfort around large groups of people, failure to care for her hair for two to three months, and

experiencing feelings of hypervigilance. (Id.) She also endorsed decreased energy levels, increased

anxiety with panic attacks, and difficulty falling asleep, performing activities of daily living, and

3 Murray stated that she took a leave of absence from work and saw a doctor, who cleared her only for non-inmate work.

(Id.) As none existed, she was medically discharged from her job. (Id.)

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concentrating. (Tr. 455-56.) On mental status examination, Dr. Levinson noted that Murray

presented with an anxious and depressed mood, but found that she exhibited a neat appearance,

cooperative attitude, normal speech, good eye contact, logical thought processes, intact judgment,

and good insight with no impairments of cognition. (Tr. 458-59.) Dr. Levinson diagnosed Murray

with PTSD and prescribed Sertraline 50 mg. (Tr. 460.)

On February 1, 2022, Murray attended a telehealth appointment with Dr. Kramer. (Tr. 504-

505.) She reported insomnia, depression, PTSD, goiter, heart palpitations, anxiety, and dysphagia.

(Id.) Dr. Kramer completed disability forms for Murray and advised her to follow up with her mental

health practitioner. (Id.)

On May 4, 2022, Murray attended a telehealth appointment with Dr. Levinson. (Tr. 463-66.)

She endorsed intermittent anxiety that was “not as intense and bearable.” (Tr. 463.) Murray reported

having dreams about her prison job but said she would not call them nightmares. (Id.) She said her

therapist was helping her feel better, and she remained able to visit family, clean, and workout. (Id.)

Murray described her sleep as “okay mostly” but said it varied depending on the day. (Id.) On mental

status examination, Murray was appropriately groomed with good eye contact. (Tr. 465.) She

displayed normal speech, appropriate insight and judgment, a logical and coherent thought process,

relevant thought associations, and adequate attention and concentration. (Id.) Dr. Levinson further

found that Murray presented with a congruent and appropriate mood/affect, and that she appeared

less depressed and anxious. (Id.) Dr. Levinson continued Murray on Sertraline. (Id.)

On June 15, 2022, Plaintiff saw Dr. Kramer for her annual physical exam. (Tr. 507-10.) Her

review of systems was negative for chest pain and palpitations and positive for sleep disturbance and

being nervous/anxious. (Tr. 508.) Murray had a blood pressure of 120/72 and a BMI of 35.88. (Tr.

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508-509.) Her physical examination was unremarkable; notably, her heart rate and rhythm, range of

motion, mood, and behavior were all normal. (Tr. 509.) Dr. Kramer diagnosed her with thyroiditis

and ordered various tests for her thyroid. (Tr. 510.)

Murray attended a telehealth medication management appointment with Dr. Levinson on

November 3, 2022. (Tr. 438-39.) She had not seen him since May 4, 2022 because she did not realize

she was supposed to schedule appointments. (Id.) Murray reported staying awake until 3:00 am

because of “[p]roblem solving at night,” but said that Melatonin helped. (Id.) She asked to restart

Sertraline, reporting that she “did better when on medicine.” (Id.) Dr. Levinson diagnosed Murray

with PTSD, noting the following symptoms: “trauma, insomnia, anxiety, depression, feels unable to

work and on disability private policy.” (Tr. 439.) He prescribed Sertraline 50 mg, once per day. (Id.)

At a primary care appointment with Dr. Kramer on April 3, 2023, Plaintiff complained of

being “under a lot of stress” and having a recent “vague episode of chest pain.” (Tr. 514.) She

requested an ECG. (Id.) Murray had a blood pressure of 120/88 and a BMI of 35.74. (Id.) Her

physical examination was normal, including a regular heart rhythm, normal range of motion, and

normal mood, affect, and behavior. (Tr. 515.) Dr. Kramer assessed anxiety and vague chest pain and

ordered an ECG. (Id.) Murray underwent the ECG that same day, which was normal. (Tr. 629-30.)

C. Opinion Evidence

1. Consultative Medical Examiner Anne Greenberg, M.D.

On May 19, 2022, Murray attended a consultative medical examination with Anne M.

Greenberg, M.D. (Tr. 351-60.) In addition to interviewing and examining Murray, Dr. Greenberg

reviewed a February 2022 Third Party Function Report and a written history form. (Tr. 351-52

(referencing Tr. 224-31, 365-66)). Dr. Greenberg noted that Murray reported “an extensive

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psychiatric history with diagnoses including anxiety, panic attacks with palpitations, and depression”

and PTSD. (Tr. 351.) Murray also reported that she saw a therapist weekly, saw a psychiatrist every

two to three months, and recently started taking Sertraline. (Id.) Dr. Greenberg noted that Murray

was also being treated for a goiter and hypothyroidism. (Id.) Regarding her activities of daily living

and social activities, Murray told Dr. Greenberg that she lived alone and did not need help at home.

(Tr. 352.) She indicated she was licensed to drive and continued to drive a car. (Id.) She also

indicated that she could cook, clean, do laundry, shop, and care for her hygiene without assistance.

(Id.) Murray reported that, to relax, she watches television, reads, listens to the radio, plays video

games, and shops. (Id.)

On physical examination, Murray weighed 246 pounds, and her blood pressure was 122/80.

(Tr. 352.) She had normal gait and stance, could walk on her heels and toes without difficulty, and

exhibited regular heartbeat with no reflex or sensory deficits, full strength, intact hand and finger

dexterity, and 100% grip bilaterally. (Tr. 352-54.) She did not need help getting on and off the exam

table, could rise from a chair without difficultly, had stable and nontender joints, and no had evident

trigger points. (Tr. 353.) Dr. Greenberg noted that Murray’s left and right knee x-rays were negative.

(Tr. 354.) Dr. Greenberg diagnosed Murray with thyroid goiter, anxiety, panic attacks, depression,

PTSD, history of AA, and nicotine use disorder. (Id.)

Dr. Greenberg completed a checkbox-style medical source statement regarding Murray’s

ability to perform work-related activities. (Tr. 355-60.) She opined that Murray was limited to the

following:4 (1) occasionally lifting and carrying between 11 and 20 pounds; (2) frequently lifting and

4 The Medical Source Statement form defines the term “frequently” as meaning “one-third to two-thirds of the time;” and

the term “occasionally” as meaning “very little to one-third of the time.” (Tr. 355.)

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carrying up to 10 pounds; (3) never lifting and carrying more than 20 pounds; (4) walking and

standing up to one hour each without interruption and four hours total in an eight-hour workday; (5)

sitting up to four hours without interruption and eight hours total in an eight-hour workday; (6)

frequently reaching, handling, fingering, feeling, and pushing/pulling; (7) frequently using her feet

for operation of foot controls; (8) occasionally climbing ladders or scaffolds and frequently climbing

stairs and ramps; (9) frequently balancing, stooping, kneeling, crouching, and crawling; (10)

occasionally tolerating exposure to unprotected heights, extreme cold, and extreme heat; (11)

frequently tolerating exposure to moving mechanical parts, operating a motor vehicle, humidity and

wetness, dusts, odors, fumes, and pulmonary irritants, and vibrations; and (12) tolerating up to a

moderate noise level. (Tr. 355-59.) Dr. Greenberg opined that these limitations had lasted or would

last for 12 consecutive months. (Tr. 360.)

Notably, throughout the evaluation form, Dr. Greenberg left blank the sections asking her to

“[i]dentify the particular medical or clinical findings (i.e., physical exam findings, x-ray findings,

laboratory test results, history, and symptoms including pain, etc.)” that supported her assessment of

the above limitations. (Tr. 355-60.)

2. State Agency Non-Examining Physicians

a. Physical

On July 5, 2022, state agency physician Charles Joseph Hubbard Jr., M.D., completed a

medical evaluation based on Murray’s medical records, including Dr. Greenberg’s consultative

examination report. (Tr. 67.) Dr. Hubbard opined that the record did not support a severe current

functional impairment in relation to Murray’s thyroid or heart/hypertension issues, and did not

establish a medically determinable impairment in relation to her alleged loss of balance or insomnia.

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(Id.) He further opined that Murray’s obesity was not a severe impairment, noting: “BMI in mid-

30’s but normal exam at [Consultative Exam].” (Id.) In support of his findings, Dr. Hubbard

observed that Dr. Greenberg’s May 19, 2022 physical examination noted “normal gait/stance,

strength, ROM, hand function.” (Id.)

Upon reconsideration, on October 31, 2022, non-examining state agency medical consultant

Pamela Irene Gianni, M.D., completed a medical evaluation based on updated records. (Tr. 76.) New

treatment records included a May 4, 2022 endocrinology visit noting that Murray’s goiter had grown,

her recent thyroid was “low level,” and no medicine was needed. (Id.) After reviewing the complete

record, Dr. Gianni agreed with Dr. Hubbard’s finding that Murray had no severe medically

determinable physical impairments. (Id.)

c. Mental

On April 1, 2022, state agency psychological consultant Nancy Kennedy, Psy.D., completed

a Psychiatric Review Technique (“PRT”) (Tr. 68-69) and Mental RFC Assessment (Tr. 70-71). In

the PRT, Dr. Kennedy found Murray had: (1) mild limitations in understanding, remembering, or

applying information; (2) mild limitations in adapting or managing herself; (3) moderate limitations

in interacting with others; and (4) moderate limitations in concentrating, persisting, or maintaining

pace. (Tr. 68.)

In the Mental RFC, Dr. Kennedy offered a series of opinions regarding Murray’s mental

functional limitations based on her review of Murray’s medical records. Specifically, Dr. Kennedy

opined that Murray was “not significantly limited” in her abilities to: (1) carry out very short and

simple instructions; (2) carry out detailed instructions; (3) sustain an ordinary routine without special

supervision; (4) work in coordination with or in proximity to others without being distracted by them;

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(5) make simple work-related decision; (6) ask simple questions or request assistance; (7) get along

with coworkers or peers without distracting them or exhibiting behavioral extremes; and (8) maintain

socially appropriate behavior and adhere to basic standards of neatness and cleanliness. (Tr. 70.) Dr.

Kennedy further opined that Murray was “moderately limited” in her abilities to: (1) maintain

attention and concentration for extended periods; (2) perform activities within a schedule, maintain

regular attendance, and be punctual within customary tolerances; (3) complete a normal workday and

workweek without interruptions from psychologically based symptoms and to perform at a consistent

pace without an unreasonable number and length of rest periods; (4) interact appropriately with the

general public; and (5) accept instructions and respond appropriately to criticism from superiors. (Id.)

Dr. Kennedy further explained as follows:

Based on the evidence of record, the claimant’s statements are found to be partially

consistent. The claimant’s basic memory processes are intact. The claimant can

understand, retain, and follow simple instructions (i.e., perform one and two step

tasks). The claimant can make simple decisions and would not require special

supervision in order to sustain a work routine. The claimant can perform simple,

routine, repetitive tasks in a stable environment.

The claimant is able to maintain socially appropriate behavior and can perform the

personal care functions needed to maintain an acceptable level of personal hygiene.

The claimant is capable of asking simple questions and accepting instruction. The

claimant is able to interact appropriately with the general public. The claimant is able

to get along with others in the workplace without distracting them. The claimant can

exercise appropriate judgment in the workplace.

. . .

The claimant is able to meet basic mental demands on a sustained basis despite the

limitations resulting from the impairments.

(Tr. 71.) On reconsideration, on October 20, 2022, state agency psychological consultant Richard

W. Williams, Ph.D., agreed with Dr. Kennedy’s PRT (Tr. 77-78) and mental RFC (Tr. 79-80).

III. Standards of Review

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A. Review of Objections to R&R

Under 28 U.S.C. § 636(b)(1), “[a] judge of the court shall make a de novo determination of

those portions of the report or specified proposed findings or recommendations to which objection is

made.” 28 U.S.C. § 636(b)(1); see Powell v. United States, 37 F.3d 1499 (Table), 1994 WL 532926

at *1 (6th Cir. Sept. 30, 1994) (“Any report and recommendation by a magistrate judge that is

dispositive of a claim or defense of a party shall be subject to de novo review by the district court in

light of specific objections filed by any party.”) (citations omitted); Orr v. Kelly, 2015 WL 5316216

at *2 (N.D. Ohio Sept. 11, 2015) (citing Powell, 1994 WL 532926 at *1). See also Fed. R. Civ. P.

72(b)(3). “A judge of the court may accept, reject, or modify, in whole or in part, the findings or

recommendations made by the magistrate judge.” 28 U.S.C. §636(b)(1).

The Sixth Circuit has held that general objections to a Magistrate Judge’s report and

recommendation are insufficient. Miller v. Currie, 50 F.3d 373, 380 (6th Cir. 1995). See also Brown

v. City of Grand Rapids, Michigan, 2017 WL 4712064 (6th Cir. 2017). “A general objection, or one

that merely restates the arguments previously presented, is not sufficient to alert the court to alleged

errors on the part of the magistrate judge.” Aldrich v. Bock, 327 F.Supp.2d 743, 747 (E.D. Mich.

2004). Rather, “[t]he objections must be clear enough to enable the district court to discern those

issues that are dispositive and contentious.” Miller, 50 F.3d at 380 (citing Howard v. Sec’y of Health

& Human Servs., 932 F.2d 505, 508–09 (6th Cir.1991)). “‘[B]are disagreement with the conclusions

reached by the Magistrate Judge, without any effort to identify any specific errors in the Magistrate

Judge's analysis that, if corrected, might warrant a different outcome, is tantamount to an outright

failure to lodge objections to the R&R.’” Arroyo v. Comm'r of Soc. Sec., 2016 WL 424939 at *3

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(E.D. Mich. Feb. 4, 2016) (quoting Depweg v. Comm'r of Soc. Sec., 2015 WL 5014361 at *1 (E.D.

Mich. Aug. 24, 2015)) (citing Howard, 932 F.2d at 509).

Moreover, parties cannot “raise at the district court stage new arguments or issues that were

not presented” before the magistrate judge's final report and recommendation. See Murr v. United

States, 200 F.3d 895, 902 n.1 (6th Cir. 2000) (“Courts have held that while the Magistrate Judge Act,

28 U.S.C. § 631 et seq., permits de novo review by the district court if timely objections are filed,

absent compelling reasons, it does not allow parties to raise at the district court stage new arguments

or issues that were not presented to the magistrate.”) See also Swain v. Comm'r of Soc. Sec., 379 Fed.

Appx 512, 517-18 (6th Cir. 2010) (“A claim raised for the first time in objections to a magistrate

judge’s report is deemed waived.”); Nasser v. Comm’r of Soc. Sec., 598 F.Supp.3d 614, 621 (E.D.

Mich. 2022), aff’d, 2022 WL 17348838 (6th Cir. Dec. 1, 2022).

B. Review of Social Security Decisions

Under the Social Security Act, a disability renders the claimant unable to engage in substantial

gainful activity because of a medically determinable physical or mental impairment that can result in

death or that can last at least twelve months. 42 U.S.C. § 423(d)(1)(A); 20 C.F.R. § 404.1505(a).

The impairment must prevent the claimant from doing the claimant's previous work, as well as any

other work which exists in significant numbers in the region where the individual lives or in several

regions of the country. 42 U.S.C. § 423(d)(2)(A). Consideration of disability claims follows a five-

step review process.5 20 C.F.R. § 404.1520.

5 Under this five step review, the claimant must first demonstrate that she is not currently engaged in “substantial gainful

activity” at the time of the disability application. 20 C.F.R. §§ 404.1520(b) and 416.920(b). Second, the claimant must

show that she suffers from a “severe impairment” in order to warrant a finding of disability. 20 C.F.R. §§ 404.1520(c)

and 416.920(c). A “severe impairment” is one that “significantly limits . . . physical or mental ability to do basic work

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The Court's review of the Commissioner's decision to deny benefits is limited to determining

whether the ALJ applied the correct legal standards and whether the findings are supported by

substantial evidence. 42 U.S.C. § 405(g). “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.’” McGlothin v. Comm'r of Soc. Sec., 299 Fed. Appx. 516, 521 (6th

Cir. 2008) (quoting Rogers v. Comm'r of Soc. Sec., 486 F.3d 234, 241 (6th Cir. 2007) (internal citation

omitted)).

If substantial evidence supports the Commissioner's finding that the claimant is not disabled,

that finding must be affirmed even if the reviewing court would decide the matter differently. Cutlip

v. Sec'y of Health & Human Servs., 25 F.3d 284, 286 (6th Cir. 1994) (citation omitted). A reviewing

court is not permitted to resolve conflicts in evidence or to decide questions of credibility. Bass v.

McMahon, 499 F.3d 506, 509 (6th Cir. 2007) (citation omitted). Moreover, the Commissioner's

decision must be affirmed even if substantial evidence also exists in the record to support a finding

of disability. Felisky v. Bowen, 35 F.3d 1027, 1035 (6th Cir. 1994) (citing Mullen v. Bowen, 800 F.2d

535, 545 (6th Cir. 1986)).

IV. Plaintiff’s Objections to the R&R

activities.” Abbott v. Sullivan, 905 F.2d 918, 923 (6th Cir. 1990). Third, if the claimant is not performing substantial

gainful activity, has a severe impairment that is expected to last for at least twelve months, and the impairment, or

combination of impairments, meets or medically equals a required listing under 20 CFR Part 404, Subpart P, Appendix

1, the claimant is presumed to be disabled regardless of age, education or work experience. See 20 C.F.R. §§ 404.1520(d)

and 416.920(d). Before considering step four, the ALJ must determine the claimant’s residual functional capacity; i.e.,

the claimant’s ability to do physical and mental work activities on a sustained basis despite limitations from her

impairments. 20 C.F.R. § 404.1520(e) and 416.930(e). At the fourth step, if the claimant’s impairment or combination

of impairments does not prevent her from doing her past relevant work, the claimant is not disabled. 20 C.F.R. §§

404.1520(e)-(f) and 416.920(e)-(f). For the fifth and final step, even if the claimant’s impairment does prevent her from

doing her past relevant work, if other work exists in the national economy that the claimant can perform, the claimant is

not disabled. 20 C.F.R. §§ 404.1520(g), 404.1560(c), and 416.920(g). See Abbot, 905 F.2d at 923.

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A. First Objection: Whether the ALJ properly articulated the supportability factor

when evaluating the medical opinions of the state agency psychological

consultants, Dr. Kennedy and Dr. Williams

In her first Objection, Murray argues that the Magistrate Judge erred in finding that the ALJ

properly articulated the supportability factor when evaluating the medical opinions of Dr. Kennedy

and Dr. Williams. (Doc. No. 12.) Specifically, Murray asserts that the ALJ improperly “conflated

the supportability and consistency analysis” by failing to “discuss any of the supporting explanations

made by” Drs. Kennedy and Williams in the decision. (Id.) Rather, Murray maintains, “the ALJ’s

findings in the decision are vague and only refer to moderate limitations in mental functioning.” (Id.

at PageID# 766.) Murray argues that the ALJ’s failure to explain her reasoning leads to “a lack of a

logical bridge between the evidence and the RFC assessment.” (Id. at PageID# 767.) Murray then

asserts (summarily) that the ALJ’s failure to properly consider the opinions of Drs. Kennedy and

Williams is harmful because “[i]f the entirety of the limitations provided by Drs. Kennedy and

Williams were given in a hypothetical to the [VE], it is likely that these limitations would have

impacted the step five findings.” (Id. at PageID# 768.) In response, the Commissioner argues that

the Magistrate Judge properly found that, reading the decision as a whole, the ALJ sufficiently

addressed the supportability and consistency of Dr. Kennedy’s and Dr. Williams’ opinions. (Doc.

No. 13.)

Under the social security regulations, an ALJ is not to “defer or give any specific evidentiary

weight, including controlling weight, to any medical opinion(s) or prior administrative medical

finding(s), including those from [the claimant's] medical sources.” 20 C.F.R. § 404.1520c(a). See,

e.g., Adams v. Comm’r, 2023 WL 6366106 at * 2 (6th Cir. Sept. 28, 2023). But the ALJ must

articulate how “persuasive” she finds “all of the medical opinions and all of the prior administrative

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medical findings in [the claimant's] case record.” 20 C.F.R. § 404.1520c(b). In evaluating the

persuasiveness of a medical opinion, an ALJ is directed to consider several factors: the opinion's

supportability and consistency; the treating source's relationship with the claimant and specialization;

and other factors, such as the medical source's familiarity with other evidence relevant to the claim.

20 C.F.R. § 404.1520c(c). Supportability and consistency are “the most important factors,” and the

ALJ must explain her consideration of them; the ALJ may, but is not required to, explain how she

considered the other factors. 20 C.F.R. § 404.1520c(b)(2). See Adams, 2023 WL 6366106 at * 2.

As to supportability, the regulations provide that “[t]he more relevant the objective medical

evidence and supporting explanations presented by a medical source are to support his or her medical

opinion(s) or prior administrative medical finding(s), the more persuasive the medical opinions or

prior administrative medical finding(s) will be.” 20 C.F.R. § 404.1520c(c)(1). In other words,

“supportability” is the extent to which a medical source's own objective findings and supporting

explanations substantiate or support the findings in the opinion.

As to consistency, the regulations provide that “[t]he more consistent a medical opinion(s) or

prior administrative medical finding(s) is with the evidence from other medical sources and

nonmedical sources in the claim, the more persuasive the medical opinion(s) or prior administrative

medical finding(s) will be.” 20 C.F.R. § 404.1520c(c)(2). Thus, “consistency” is the extent to which

a medical source's opinion findings are consistent with the evidence from other medical and

nonmedical sources in the record.

Here, the ALJ considered Murray’s subjective complaints at step four, including that she

suffers from insomnia, panic attacks, irritability, fatigue, depression, elevated blood pressure and

headaches. (Tr. 23-24.) The ALJ then discussed Murray’s medical records, including her mental

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health treatment records with Dr. Levinson and Ms. Elliott. (Tr. 24-25.) Based on her review of the

record, the ALJ concluded as follows:

The medical record shows the claimant has depression, anxiety and PTSD and is

limited in her mental functioning (Exhibits 6F, 7F, 8F). However, overall, the

claimant has had little mental health treatment. She had approximately 6 mental health

appointments since 11/2021 (Exhibit 7F). This was due to claimant’s

misunderstanding that she had to schedule appointments. Despite very little mental

health treatment, the record does not document any acute symptoms or episodes of

decompensation leading to emergent or inpatient treatment. Additionally, the May 4,

2022, mental health treatment note indicates claimant had only intermittent anxiety

and described it as less intense and was bearable (Exhibit 7F/34). The mental status

examination on May 4, 2022, shows claimant was less depressed and anxious (Exhibit

7F/34). The mental health record generally shows normal examinations. Mental

health records are generally limited to treatment plans and medication checks with no

longitudinal therapy notes. Overall, the records indicate the claimant had improvement

with treatment with some residual anxiety and some issues with rapid heartbeat or

palpitations. She takes medications for anxiety and insomnia.

(Tr. 25.) The ALJ then discussed the medical opinion evidence. Regarding the opinions of Drs.

Kennedy and Williams, the ALJ found as follows:

Nancy Kennedy, Psy.D., and Richard Williams, Ph.D., found the claimant was

moderately limited in mental functioning (Exhibits 1A, 3A). The undersigned finds

these opinions are generally persuasive as they are consistent and supported by the

medical examinations and claimant’s testimony and reported daily activities.

(Tr. 26.) The ALJ assessed the following RFC: “the claimant has the residual functional capacity to

perform a full range of work at all exertional levels but with the following non-exertional limitations:

routine tasks with detailed but uninvolved instructions, no contact with the public, occasional

interactions with coworkers, occasional interactions with supervisors, and occasional changes in work

processes or tasks.” (Tr. 22.)

In a lengthy and thorough R&R, the Magistrate Judge carefully considered Murray’s

argument that the RFC was not supported by substantial evidence because the ALJ found the opinions

of Drs. Kennedy and Williams to be “generally persuasive” but failed to incorporate their opinions

16

that Murray was limited to performing one and two step tasks, making simple decisions, and working

in a stable environment. (Doc. No. 11 at PageID#s 742-757.) The ALJ found that “[a]lthough the

ALJ’s analysis of the state agency psychological opinions was brief, it was informed by her prior

written analysis of Ms. Murray’s subjective reports and treatment records.” (Id. at PageID# 746.)

The Magistrate Judge explained that “[i]n context, ... the ALJ’s explanation as to why she found the

state agency’s opinions ‘generally persuasive’ was sufficient to address supportability and

consistency with the regulations.” (Id.)

The Magistrate Judge then considered Murray’s argument that the ALJ violated Social

Security Ruling (“SSR”) 96-8p6 when she adopted mental limitations in the RFC that conflict with

Drs. Kennedy and Williams’ proposed limitations without explaining why the conflicting limitations

were not adopted. (Id. at PageID# 748.) The Magistrate Judge concluded that the limitation in the

RFC to “occasional changes in work processes or tasks” did not conflict with Dr. Kennedy’s and Dr.

Williams’ opinion that Murray could perform work in a “stable environment” and, therefore, the ALJ

was not required under SSR 96-8p to provide further explanation for omitting the “stable

environment” limitation from the RFC. (Id. at PageID#s 754-756.) The Magistrate Judge agreed

with Murray, however, that the limitation in the RFC to “routine tasks with detailed but uninvolved

instructions” did conflict with Dr. Kennedy’s and Dr. Williams’ opinion that Murray could perform

“one and two step tasks.” (Id. at PageID#s 749-752.) The Magistrate Judge further found that the

ALJ failed to explain why she did not adopt that particular limitation, in violation of SSR 96-8p. (Id.)

6 SSR 96-8p requires an ALJ to consider all medical opinions in the RFC assessment and, where the assessment “conflicts

with an opinion from a medical source,” the ALJ “must explain why the opinion was not adopted.” SSR 96-8p, Assessing

Residual Functional Capacity in Initial Claims, 1996 WL 374184 at * 7 (July 2, 1996).

17

The Magistrate Judge concluded, however, that the ALJ’s error was harmless. First, the

Magistrate Judge noted that Murray “does not explain how she was ‘prejudiced on the merits’ or

‘deprived of a substantial right’ by the ALJ’s failure to comply with SSR 96-8p. (Id. at PageID#

753.) Second, the Magistrate Judge found that the error was harmless because the VE testified that

Murray could perform the job of laborer, which the Dictionary of Occupational Titles (“DOT”)

defines as a “Reasoning Level 1” position that can be performed by a person who is able to “carry

out simple one- or two-step instructions.” (Id. at PageID#s 751-754) Moreover, the Magistrate Judge

noted that the VE testified there were over 400,000 laborer jobs in the national economy at Reasoning

Level 1, which constitutes a “significant” number of jobs under the Sixth Circuit authority.7 (Id.)

The Court finds as follows. As an initial matter, the Court notes that Murray has not objected

to the Magistrate Judge’s conclusions that the ALJ properly evaluated the consistency of Dr.

Kennedy’s and Dr. Williams’ proposed limitations; i.e., the extent to which the opinions of Drs.

Kennedy and Williams are consistent with the evidence from other medical and nonmedical sources

in the record. Rather, Murray objects only to the Magistrate Judge’s finding that the ALJ properly

articulated the supportability factor; i.e., the extent to which Dr. Kennedy’s and Dr. Williams’ own

objective findings and supporting explanations substantiate or support the findings in their opinions.

For the following reasons, the Court finds this objection to be without merit.

As the Magistrate Judge correctly notes, an ALJ is permitted to rely on previously articulated

information to support her analysis of opinion evidence. See, e.g., Crum v. Comm’r of Soc. Sec., 660

Fed. Appx. 449, 457 (6th Cir. 2016) (“No doubt, the ALJ did not reproduce the list of these treatment

7 The Magistrate Judge also found that Murray had waived any argument that the ALJ’s failure to adopt a limitation to

“simple decisions” violated SSR 96-8p. (Id. at PageID# 749, fn 3.)

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records a second time when she explained why Dr. Bell’s opinion was inconsistent with this record.

But it suffices that she listed them elsewhere in her opinion”). See also McCarty v. Comm’r of Soc.

Sec., 2024 WL 4695900 at * 8 (N.D. Ohio Nov. 6, 2024) (noting that “the ALJ’s decision must be

read as a whole and with common sense”); Bryant v. Comm'r of Soc. Sec., 2019 WL 5684456 at *10

(N.D. Ohio Nov. 1, 2019) (“Although the ALJ must discuss significant evidence supporting her

decision and explain her conclusions with sufficient detail to permit meaningful review, there is no

requirement that the ALJ incorporate all the information upon which she relied into a single

paragraph.”).

Moreover, “[w]hether a medical source's opinion is supported by the record may necessarily

overlap with whether a medical source's opinion is consistent with the record, as the opinion's support

will typically come from other evidence in the record.” Guthrie v. Comm’r of Soc. Sec, 2023 WL

6258259 at * 3 (N.D. Ohio Sept. 26, 2023). See also Rambo v. Comm’r of Soc. Sec., 2024 WL

3813417 at * 7 (N.D. Ohio July 9, 2024), report and recommendation adopted by 2024 WL 4532777

(N.D. Ohio Oct. 21, 2024); Bigford v. Comm’r of Soc. Sec., 2024 WL 3083251 at * 3 (W.D. Mich.

June 21, 2024) (“The ALJ's specific references to portions of the medical record which undercut

Nwankwo, Grubelich, and Abbasi's opinions evidence her consideration of the supportability and

consistency factors. This is sufficient, even if the ALJ did not specifically code a particular portion

of the record to ‘consistency’ or ‘supportability.’”) Thus, even where an ALJ appears to conflate the

terms “supportability” and “consistency,” courts have found no error where the court is able to follow

the ALJ’s reasoning and is satisfied that the ALJ properly performed the requisite analysis of these

factors. See, e.g., Potts v. Comm’r of Soc. Sec., 2024 WL 4660850 at * 8-9 (N.D. Ohio Nov. 4, 2024),

report and recommendation adopted by 2025 WL 1427632 (N.D. Ohio May 19, 2025).

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Reading the ALJ decision herein as a whole, the Court finds that the ALJ adequately explained

her consideration of the supportability factor when finding that the opinions of Dr. Kennedy and Dr.

Williams were “generally persuasive.” Courts in this Circuit have found that “’supportability’

concerns an opinion’s reference to diagnostic techniques, data collection procedures/analysis, and

other objective medical evidence.” Reusel v. Comm’r of Soc. Sec., 2021 WL 1697919 at * 7, n. 6

(N.D. Ohio April 29, 2021). See also Rambo, 2024 WL 3813417 at * 7. Here, in their respective

opinions, Dr. Kennedy and Dr. Williams noted that Murray had been diagnosed with PTSD, had no

history of in-patient psychiatric admission, and had been prescribed psychotropic medications. (Tr.

71, 80.) Dr. Kennedy and Dr. Williams also noted that Murray’s activities of daily living (or “ADLs”)

“appear to be adequate from a psychiatric perspective.” (Id.) Dr. Kennedy and Dr. Williams then

referenced Dr. Levinson’s largely normal mental health examination findings from Murray’s January

10, 2022 appointment. (Id.) Specifically, Dr. Kennedy and Dr. Williams noted that Dr. Levinson

found that, while Murray exhibited depressed/anxious mood, she was also alert and oriented and

presented with a neat appearance, cooperative attitude/behavior, normal speech, good eye contact,

logical thought process, and good judgment and insight with no impairments of cognition. (Id.) See

also Tr. 458-59.

The ALJ found the opinions of Dr. Kennedy and Dr. Williams that Murray is moderately

limited in mental functioning to be “generally persuasive” because “they are consistent and supported

by the medical examinations and claimant’s testimony and reported daily activities.” (Tr. 26.)

Certainly, it would have been preferable for the ALJ to have included a more complete discussion of

supportability in the paragraph of her decision that discusses her analysis of Dr. Kennedy’s and Dr.

Williams’ opinions. However, the ALJ fully discussed the medical record just prior to her analysis

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of Dr. Kennedy’s and Dr. Williams’ opinions. (Tr. 24-25.) Among other things, the ALJ summarized

Murray’s January 2022 mental health assessment (Tr. 24), which (notably) is also expressly

referenced by Drs. Kennedy and Williams as an “additional explanation” for their opinions. (Tr. 71,

80.) The ALJ also noted (as did Drs. Kennedy and Williams) that (1) Murray had no history of

inpatient mental health treatment (Tr. 25); (2) her “mental health record generally shows normal

examinations” (Tr. 25); and (3) Murray reported a broad range of activities of daily living, including

managing money, paying bills, shopping, driving, and reading (Tr. 22).

Thus, when reading the decision as whole, the Court finds that the ALJ’s overall discussion

of Murray’s history of mental health treatment, largely normal January 2022 mental health assessment

findings, and reported range of activities of daily living, is sufficient to adequately articulate her

supportability assessment with regard to the opinions of Drs. Kennedy and Williams. In other words,

by reading the decision in its entirety, the Court is able to follow the ALJ’s reasoning and is satisfied

that the ALJ properly performed the requisite analysis of the supportability factor with regard to the

state agency psychologists’ opinions.

In so finding, the Court rejects Murray’s argument that the Sixth Circuit’s decision in Kinney

v. Comm’r of Soc. Sec., 2024 WL 2273365 (6th Cir. May 20, 2024) requires a different result. In

Kinney, the ALJ found a medical opinion to be “consistent with and supported by the record as a

whole” and “persuasive,” but then omitted a limitation contained therein requiring flexible breaks

without explanation. Kinney, 2024 WL 2273365 at *5. The Sixth Circuit determined that “although

the ALJ was not required to incorporate the flexible break scheduling limitation, the failure to do so

without explaining its omission warrant[ed] reversal” given the fact that the ALJ found the medical

examiner's opinion to be persuasive. Id. at * 9.

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The Court finds Kinney to be distinguishable from the instant case for several reasons. First,

unlike Kinney, the ALJ in the instant case did not state that she found the opinions of Drs. Kennedy

and Williams fully persuasive. Rather, the ALJ found that Dr. Kennedy’s and Dr. Williams’ opinions

were only “generally persuasive.” Courts have distinguished Kinney on this basis. See, e.g., Haahr

v. Comm’r of Soc. Sec., 2024 WL 5242214 at * 4 (N.D. Ohio Dec. 30, 2024) (distinguishing Kinney

because “here the ALJ did not state he found the medical opinion persuasive, but only assigned it

‘some weight’”).

Second, and notably, in Kinney, the VE testified on cross-examination that a flexibility

limitation would be considered an accommodation. See Kinney v. Comm’r of Soc. Sec., 2023 WL

5042599 at * 6 (N.D. Ohio June 12, 2023). See also Kinney v. Comm’r of Soc. Sec., Case No.

3:22cv1125 (N.D. Ohio) (Doc. No. 5 at Tr. 73.) Thus, the ALJ’s failure to include a flexible break

limitation in the RFC could not be considered harmless error. In the instant case, however, the

Magistrate Judge concluded that, even if the ALJ erred in failing to include Dr. Kennedy’s and Dr.

Williams’ “one and two step task” limitation in the RFC, any such error was harmless because the

VE testified that Murray could perform the job of laborer, which the DOT defines as a “Reasoning

Level 1” position that can be performed by a person who is able to “carry out simple one- or two-step

instructions.” (Doc. No. 11 at PageID#s 751-754.) The Magistrate Judge further noted the VE’s

testimony that there were over 400,000 laborer jobs in the national economy at Reasoning Level 1,

and found that this constitutes a “significant” number of jobs under the Sixth Circuit authority. (Id.)

Murray does not object to the Magistrate Judge’s conclusion that a district court may

undertake a harmless error analysis in this context. Nor does she object to the Magistrate Judge’s

findings that (1) Dr. Kennedy’s and Dr. Williams’ opinions that Murray is limited to “one and two

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step tasks” is generally equivalent to the DOT language for Reasoning Level 1 jobs; (2) the job of

laborer is a Reasoning Level 1 job with over 400,000 positions nationally available; and (3) that a

significant number of jobs therefore exist in the national economy that Murray could perform even

with a one to two step task limitation. Thus, any objections to the above findings are waived.

Instead, Murray argues that the ALJ’s “failure to properly consider [Dr. Kennedy’s and Dr.

Williams’] opinions when assessing the RFC at step four and then when proffering the hypotheticals

to the [VE] during the hearing leads to harmful error” because “if the entirety of the [proposed]

limitations ... were given in a hypothetical to the [VE], it is likely that these limitations would have

impacted the step five findings.” (Doc. No. 12 at PageID# 768.) Murray’s argument is without merit.

As an initial matter, Murray has not raised any specific objection to the Magistrate Judge’s conclusion

that the limitation in the RFC to “occasional changes in work processes or tasks” does not conflict

with Dr. Kennedy’s and Dr. Williams’ opinion that Murray could perform work in a “stable

environment.” Nor does Murray object to the Magistrate Judge’s finding that she waived any

argument regarding the ALJ’s failure to adopt a limitation to “simple decisions” in the RFC. Thus,

Murray has waived any argument that the ALJ’s failure to present a hypothetical to the VE that

included the “entirety of the limitations” proposed by Drs. Kennedy and Williams (i.e., that included

their proposed “stable environment” and “simple decisions” limitations) constituted harmful error.

Rather, at best, Murray is limited to arguing that the ALJ’s failure to include the “one and two

step tasks” limitation in a hypothetical to the VE constituted harmful error. Murray failed to raise

this argument, however, in her briefing before the Magistrate Judge and she may not raise it now for

the first time in her Objection. See Murr, 200 F.3d at 902, n.1 (noting that parties may not raise at

the district court stage “new arguments or issues that were not presented to the magistrate.”); Swain,

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379 Fed. Appx at 517-18 (“A claim raised for the first time in objections to a magistrate judge’s report

is deemed waived.”) And, even if she could, Murray fails entirely to acknowledge or address the

Magistrate Judge’s finding that, even if the ALJ had included a “one to two step task” limitation in

the RFC, there would be still over 400,000 laborer jobs available in the national economy that Murray

would perform. Thus, and for all the reasons discussed above, Murray’s “harmful error” argument is

rejected.

Accordingly, the Court finds that Murray’s first Objection is without merit and overruled.

B. Second Objection: Whether the Magistrate Judge erred in finding that the ALJ

properly articulated the persuasiveness of consultative examiner Dr. Greenberg

In her second Objection, Murray challenges the Magistrate Judge’s conclusion that the ALJ

properly evaluated Dr. Greenberg’s opinion. (Doc. No. 12 at PageID# 768.) Murray first maintains

that the Magistrate Judge erred in finding that the ALJ properly discounted Dr. Greenberg’s opinion

on the basis that Murray “has no positive clinical findings on examination.” (Id.) Murray maintains

that this statement is not supported by substantial evidence in light of Murray’s history of abnormal

blood pressure and respiratory rate readings. (Id.) Murray next asserts that the ALJ’s rejection of

Dr. Greenberg’s opinion is flawed because she failed to appropriately consider certain physical

symptoms that are associated with her panic attacks. (Id.) She argues that “these physical symptoms

are consistent with the reduced exertional level as assessed by Dr. Greenberg and should have been

discussed [by the ALJ] when evaluating the consistence of her opinion.” (Id. at PageID# 770.) In

response, the Commissioner asserts that the R&R was well reasoned and well supported by law.

(Doc. No. 13.)

At step four, the ALJ discussed the medical evidence regarding Murray’s physical

impairments as follows:

24

Claimant was scheduled to return to work on November 16, 2021, but had rapid

heartbeat and anxiety and asked for a letter stating she could not work (Exhibits 8F).

She also complained of depression and sleep disturbance. Her primary care physician

reported on November 20, 2021 that the claimant had a normal examination. He

diagnosed claimant with anxiety, but noted this was stable, and had symptoms of rapid

heartbeat. She was given melatonin (Exhibit 6F). Exam on November 30, 2021

showed positive palpitations but normal mood and affect (Exhibits 6F, 8F). On

February 1, 2022 claimant had disability forms filled out by her primary care physician

due to insomnia, depression, PTSD, goiter, heart palpitations, and dysphagia (Exhibit

8F/11). Primary care treatment notes in April 2023 indicate claimant was under stress,

had blood pressure of 114/74, and had normal cardio and pulmonary examination. She

was diagnosed with vague chest pain (Exhibit 8F/33).

(Tr. 24.) The ALJ then evaluated Dr. Greenberg’s opinion, finding it to be “not persuasive” as

follows:

Anne Greenberg, M.D., completed a consultative examination on May 19, 2022

(Exhibit 5F). She reported claimant had an extensive psychiatric history with

diagnoses of anxiety, panic attacks with palpitations, and depression. She noted

clamant’ s PTSD was diagnosed recently and that claimant goes to the psychiatrist 2-

3 times a month. Dr. Greenberg stated claimant was also treated for goiter, with a

needle aspiration planned, and hypothyroidism. She reported the claimant drank 1 ½

bottles of wine a day, but stopped in 2022. On examination Dr. Greenberg found the

claimant weighed 256 pounds, had normal gait and stance, full squat, no reflex or

sensory deficits, full strength, and 100% grip. Bilateral knee x-rays were negative.

Claimant was diagnosed with thyroid goiter, anxiety, panic attacks, depression, PTSD,

history of AA and nicotine use disorder. In a medical source statement, Dr. Greenberg

found the claimant could perform a range of light work with lifting and carrying

limited to 10-20 pounds, standing and walking limited to 4 hours out of 8, 1 hour at a

time, and postural and environmental limitations (Exhibits 5F). The undersigned

finds this opinion is not persuasive as it is internally inconsistent and is not

supported by the other evidence of record. The claimant has no positive clinical

findings on examination, yet Dr. Greenberg limits her to light work. The record

also shows no medical examination findings in the longitudinal treatment records

to support a limited to light work (Exhibits 6F, 8F).

(Tr. 25-26) (emphasis added). The ALJ then found that the opinions of state agency physicians Dr.

Hubbard and Dr. Gianni that Murray “had no severe physical impairments” were persuasive “as they

are consistent with the medical examination findings.” (Tr. 26.) As noted above, the ALJ did not

include any exertional (i.e., physical) limitations in the RFC. (Tr. 22.)

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In the R&R, the Magistrate Judge first found that Murray “has failed to show that the ALJ

misrepresented the consultative examination report when she observed that the report reflected ‘no

positive clinical findings on examination.’” (Doc. No. 11 at PageID# 759.) The Magistrate Judge

noted that, while the ALJ’s analysis did not specifically reference Murray’s blood pressure or

respiratory rate, the ALJ “was not required to discuss each piece of data in [her] opinion, so long as

[she] consider[ed] the evidence as a whole and reach[ed] a reasoned conclusion.’” (Id.) (quoting

Boseley v. Comm’r of Soc. Sec., 397 Fed. Appx 195, 199 (6th Cir. 2010)). The Magistrate Judge

further observed that Murray reported a medical history “[n]egative for hypertension, diabetes, heart

attack, other heart disease, asthma, emphysema, seizures, or head injury” (Tr. 351) and that Dr.

Greenberg did not diagnose any physical impairments relating to Plaintiff’s weight, blood pressure,

or respiration (Tr. 354). Considering the largely normal physical examination findings recorded in

Dr. Greenberg’s Report (Tr. 352-54), the Magistrate Judge found that “substantial evidence supported

the ALJ’s observation that the consultative examination report contained ‘no positive clinical findings

on examination.’” (Doc. No. 11 at PageID# 759.)

The Court agrees with the Magistrate Judge. While Murray reported a history of “panic

attacks with palpitations” (Tr. 351), Dr. Greenberg’s physical examination findings were normal,

including that Murray was in no acute distress with regular heart rhythm, normal chest and lungs,

normal pulses, and no edema or muscle atrophy. (Tr. 353.) Additionally, as the Magistrate Judge

correctly notes, Murray did not report a medical history or past diagnosis of hypertension or heart

disease, and Dr. Greenberg did not diagnose either of these conditions. (Tr. 351, 354.) This is

consistent with the medical record as a whole, which largely shows normal physical examination

findings, including normal heartbeat rhythm in November 2021 (Tr. 492-493); normal heart rate and

26

rhythm and normal blood pressure in June 2022 (Tr. 508-509); and normal ECGs in December 2021

and April 2023 (Tr. 498, 629-630). In light of the above, the Court finds that the ALJ’s determination

that Dr. Greenberg’s report was not persuasive because Murray “has no positive clinical findings on

examination” is supported by substantial evidence.8

The Magistrate Judge next rejected Murray’s argument that the ALJ improperly overlooked

her mental health records when evaluating the persuasiveness of Dr. Greenberg’s opinion. (Doc. No.

11 at PageID# 760-764.) The Magistrate Judge noted that, earlier in the decision, the ALJ explicitly

considered Murray’s reports of panic attacks and physical examination findings of elevated blood

pressure, palpitations, and rapid heartbeat. (Id.) The Magistrate Judge further observed that “the ALJ

additionally considered and found persuasive the opinions of the state agency consultants [i.e., Dr.

Hubbard and Dr. Gianni] that Ms. Murray’s physical medically determinable impairments were not

severe.” (Id.) Based on the above, the Magistrate Judge found that substantial evidence supported

the ALJ’s finding that “no medical examination in the longitudinal records” supported a limitation to

light work. (Id.)

Once again, the Court agrees with the Magistrate Judge. Substantial evidence supports the

ALJ’s finding that Dr. Greenberg’s report was not persuasive because the record does not contain

medical examination findings that support restricting Murray to light work. As noted above, the ALJ

acknowledged Murray’s complaints of elevated blood pressure, rapid heartbeat, and sweaty hands

8 The Court notes that Murray asserts (summarily) that she had an abnormal blood pressure and respiratory rate during

her consultative examination. (Doc. No. 12 at PageID# 768.) Dr. Greenberg recorded Murray’s blood pressure as 122/80

and her respiratory rate as 18/minute. (Tr. 352.) Murray cites no evidence to support her assertion that these readings

are “abnormal.” In fact, the Court notes in passing that the Cleveland Clinic’s website indicates that a normal blood

pressure for an adult is 90/60 to 120/80, and a normal respiratory rate is 12 to 18 breaths per minute. See

https://my.clevelandclinic.org/health/articles/10881-vital-signs.

27

associated with her panic attacks. (Tr. 23-25.) The ALJ also acknowledged that Murray was positive

for palpitations in November 2021. (Tr. 24.) However, the ALJ noted that Murray had a normal

cardio and pulmonary examination in April 2023. (Id.) Additionally, as noted above, the medical

record as a whole largely shows normal physical examination findings, including normal heartbeat

rhythm in November 2021 (Tr. 492-493); normal heart rate and rhythm and normal blood pressure in

June 2022 (Tr. 508-509); and normal ECGs in December 2021 and April 2023 (Tr. 498, 629-630).

And Dr. Hubbard and Dr. Gianni both concluded that Murray did not have any severe medically

determinable impairments. (Tr. 67, 76.)

While Murray cites evidence indicating that she occasionally exhibited a rapid heart rate,

shortness of breath, and elevated blood pressure, she has failed to demonstrate that the ALJ’s

conclusion is not supported by substantial evidence. The substantial evidence standard ... presupposes

that there is a zone of choice within which the decisionmakers can go either way, without interference

by the courts.” Mullen v. Bowen, 800 F.2d 535, 545 (6th Cir. 1986). “Therefore, if 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.’” Blakley v. Comm’r of

Soc. Sec., 581 F.3d 399, 406 (6th Cir. 2009) (quoting Key v. Callahan, 109 F.3d 270, 273 (6th Cir.

1997)).

For all the reasons set forth above, the Court finds that substantial evidence supports the ALJ’s

decision that Dr. Greenberg’s opinion was not persuasive because Murray’s “medical examination

findings in the longitudinal treatment records” do not support a limitation to light work. Murray’s

second Objection is, therefore, without merit and overruled.

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V. Conclusion

For all of the foregoing reasons, Plaintiff’s Objections (Doc. No. 12) are overruled. The Court

accepts the Magistrate Judge’s Report and Recommendation (Doc. No. 11) as set forth herein, and

the Commissioner’s decision is affirmed.

IT IS SO ORDERED.

s/Pamela A. Barker

PAMELA A. BARKER

Date: August 7, 2025 U. S. DISTRICT JUDGE

29