Church v. Commissioner of Social Security

IN THE UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF OHIO

EASTERN DIVISION

MICHAEL JAMES CHURCH, CASE NO. 3:25-cv-390

Plaintiff, DISTRICT JUDGE

JEFFREY J. HELMICK

vs.

MAGISTRATE JUDGE

COMMISSIONER OF SOCIAL JAMES E. GRIMES JR.

SECURITY,

Defendant. REPORT &

RECOMMENDATION

Plaintiff Michael Church filed a Complaint against the Commissioner of

Social Security seeking judicial review of the Commissioner’s decision denying

disability insurance benefits and supplemental security income. This Court

has jurisdiction under 42 U.S.C. §§ 405(g) and 1383(c). The Court referred this

matter to a Magistrate Judge under Local Rule 72.2(b)(1) for the preparation

of a Report and Recommendation. Following review, and for the reasons stated

below, I recommend that the District Court vacate and remand the

Commissioner’s decision.

Procedural history

In June and August 2022, Church filed applications for disability

insurance benefits and supplemental security income, respectively, alleging a

disability onset date of December 28, 2021.1 Tr. 252, 255, 262. In his

applications, Church claimed disability due to depression; bipolar disorder;

anxiety; back disorders, including cervical spine osteoporosis, status-post

fusion, and cervical and lumbar spine degenerative disc disease; arthritis; and

irritable bowel syndrome. Tr. 284. The Social Security Administration denied

Church’s applications and his motions for reconsideration. Tr. 88, 99, 110, 120.

Church then requested a hearing before an Administrative Law Judge (ALJ).

Tr. 208.

In October 2023, an ALJ held a hearing, during which Church and a

vocational expert testified. Tr. 41–87. In February 2024, the ALJ issued a

written decision finding that Church was not disabled. Tr. 17–35. The ALJ’s

decision became final on January 16, 2025, when the Social Security Appeals

Council declined further review. Tr. 1–3; see 20 C.F.R. § 404.981.

Church filed this action on February 27, 2025. Doc. 1. He asserts the

following assignment of error, which is reproduced as written:

Whether the ALJ erred ALJ erred in her evaluation of the medical

opinions and prior administrative medical findings and erred in her

evaluation of the prior ALJ’s decision.

Doc. 8, at 1.

1 “Once a finding of disability is made, the [agency] must determine the

onset date of the disability.” McClanahan v. Comm’r of Soc. Sec., 193 F. App’x

422, 425 (6th Cir. 2006).

Evidence

Personal and vocational evidence

Church was 50 years old on his alleged disability onset date. Tr. 33. He

completed two years of college and used to work in sales and as a vehicle

assembler. Tr. 76, 285.

Medical evidence2

Records show that Church sought treatment from Coleman Psychiatry

in December 2020. See Tr. 567–69 (August 2022 Coleman Psychiatry note

summarizing past visits beginning with December 2020). This summary shows

that in December 2020, Church was taking Cymbalta and reported a decrease

in his mental health symptoms, but continued to experience periods of

depression and “high anxiety.” Tr. 569. The provider increased Church’s

Cymbalta dosage. Tr. 569.

In February 2021, Church followed up at Coleman Psychiatry with

Nurse Practitioner Steven Mates. Tr. 727, 733. Church reported “ups and

downs.” Tr. 727. He had days where his mind raced and he would get

overwhelmed, and he would have to “lie down and let it pass.” Tr. 727. On other

days, he had “high energy,” which caused him to overextend physically and

aggravate his chronic pain issues, leading to depression. Tr. 727. Church

reported that his medications helped “because the extremes [we]ren’t too bad

2 Church only challenges the ALJ’s evaluation of his mental impairments,

so only this evidence is reproduced here.

anymore.” Tr. 727. He carried diagnoses of bipolar disorder with moderate-to-

severe “anxious distress” and generalized anxiety disorder. Tr. 731. Church’s

medications included Buspar for anxiety, Elavil for sleep, Tegretol for mood

regulation, and Cymbalta for depression. Tr. 732.

In April 2021, Church told Mates that his wife had left him. Tr. 734.

Church reporting doing “ok” and said that he had met someone else who

seemed to understand him better. Tr. 734. Church said that he had racing

thoughts, which made it difficult to organize his thoughts and to speak. Tr.

734. He also reported a poor memory. Tr. 734. Mates prescribed Trileptal to

replace Tegretol. Tr. 739.

In June 2021, Church had a counseling session at Coleman Counseling

with Licensed Social Worker Drew Jennings. Tr. 658. Church reported “some

thought blocking and extreme irritation.” Tr. 658. Jennings observed that

Church was cooperative, pleasant, and retained clear speech throughout the

session. Tr. 658.

In September 2021, Church told Mates that his mood was stable most of

the time. Tr. 755. He “still had moments where he [wa]s racing” and he said

that “he has always been paranoid,” which negatively affected his personal

relationships. Tr. 755. Mates prescribed Abilify for paranoia. Tr. 760. Later

that month, Church saw Jennings for counseling. Tr. 670. Jennings wrote that

Church was cooperative, exhibited clear speech, and maintained clear eye

contact during the session. Tr. 670. Jennings commented that Church was

“often combative” and at times during the session “resistant to treatment

recommendations.” Tr. 670.

The next month, Church reported that Abilify was helping with

paranoia. Tr. 762. His mind “still race[d] but [was] overall doing well.” Tr. 762.

Church “just need[ed] [medication] refills” that day, Tr. 762, which Mates

provided, Tr. 767.

In December 2021, Church had a visit with Mates and said that he was

not sleeping well, getting two-to-three hours of sleep at night. Tr. 770. This left

him feeling groggy and tired during the day. Tr. 770. Church said that his mood

was stable and his depression and anxiety were “doing ok.” Tr. 770. Mates

increased Church’s Elavil dosage to help with sleep. Tr. 775. That day, Church

had a counseling session with Jennings. Tr. 678. Jennings described Church

as cooperative and pleasant. Tr. 678. Church had normal speech but was “often

tangential during the session” when discussing his symptoms. Tr. 678. He

described racing thoughts and difficulty completing tasks. Tr. 678–79. Church

reported that his mood symptoms had worsened since his then-recent Covid-

19 illness and resultant isolation. Tr. 678–79.

About a week later, Church saw Licensed Social Worker Daphne Lindo

at Health Partners of Western Ohio. Tr. 512. He reported “improvement in

ruminative anxiety.” Tr. 512. Church said that he was “actively seeking work”

and felt frustrated that he could not do the things he used to do. Tr. 513.

In early April 2022, Church saw Jennings for a counseling session. Tr.

684. Jennings observed Church to be cooperative and pleasant, with clear

speech and logical thoughts. Tr. 684. Church told Jennings that his “anxious

‘racing thoughts’ continue to be his primary mood symptom.” Tr. 684. He

reported decreased sociability. Tr. 684. He said that he felt anxious about his

disability application being rejected, but remained optimistic “given the level

of support he receive[d] from his girlfriend, kids, and family.” Tr. 684. The next

day, Church saw Mates. Tr. 784. Church said that he was happy that he no

longer had racing thoughts. Tr. 784. His sleep was “ok” and his anxiety was “a

little high sometimes,” but he managed it “ok” and was satisfied with his

current medication regime. Tr. 784.

About two weeks later, Church underwent a diagnostic assessment with

Jennings. Tr. 707. Church reported severe anxiety for three to four years,

which had developed into racing thoughts. Tr. 707. His racing thoughts

prevented him from working and interacting with others outside his home. Tr.

707. Jennings described Church as pleasant and cooperative, albeit “often

tangential and difficult to follow.” Tr. 707. Church reported moderately severe

limitations in the following activities of daily living: communication; problem

solving; leisure; and coping skills. Tr. 714–15. He indicated a severe limitation

with productivity. Tr. 715. On exam, Church had cooperative and agitated

behavior, clear speech, tangential and racing thoughts, preoccupied thought

content, fair to poor insight and judgment, and impaired attention and

concentration. Tr. 716–17. Jennings wrote that Church was difficult to

redirect, and he often asked Jennings to repeat the questions, indicating that

he had issues with memory. Tr. 716–17.

In June 2022, Church followed up with Mates and said that his mood

was “up and down,” “sometimes stable,” and “much better than when he first

started at Coleman.” Tr. 792. Church was “struggling to decide whether to try

and work again or stick with the plan to get [disability.]” Tr. 792. He said that

he would likely pursue disability because his physical conditions had not

improved. Tr. 792.

In July 2022, Church saw Lindo at Health Partners of Western Ohio.

Tr. 503. Church reported that he was taking Abilify, which reduced his

paranoia and some of his racing thoughts. Tr. 503. He also said that he still

had difficulty sleeping and low energy. Tr. 503. Lindo assessed Church with

bipolar I disorder, “most recent episode, mixed - moderate.” Tr. 504.

In early August 2022, Mates completed a checklist form cataloging

Church’s work-related mental limitations. Tr. 490–91. Mates listed Church’s

diagnosis as bipolar disorder, which caused paranoia, mood fluctuations, and

“some anxiety.” Tr. 490. Mates opined that due to his impairment, Church

would have no more than mild difficulties in understanding, remembering or

applying information, interacting with others, and adapting or managing

himself. Tr. 490. He indicated that Church would have moderate difficulties in

maintaining concentration, persistence, or pace. Tr. 490. Church would be

absent from work two days per month on average. Tr. 490. Mates indicated

that Church would have mild limitations remembering locations and work-like

procedures and no limitations carrying out very short and simple instructions.

Tr. 491. Church would be moderately limited in his “ability to complete a[n] 8-

hour work-day and workweek without interruption from psychologically based

symptoms and to perform a consistent pace without an unreasonable number

and length of rest periods.” Tr. 491. He would have mild limitations getting

along with coworkers or peers without distracting them or exhibiting

behavioral extremes, and mild limitations responding appropriately to changes

in the work setting. Tr. 491. Mates wrote that Church had “[n]o medication

adjustments” for six months, since February 2022. Tr. 491.

A week later, Church told Mates that he hadn’t been depressed “too

much” but that his mood “still [went] up and down.” Tr. 567. Mates commented

that Church was “agreeable now to increase Abilify” to improve mood

regulation. Tr. 567. Church said that his bigger problem was “memory and task

completion.” Tr. 567. On exam, Church had normal speech, logical thought

process, racing thoughts, and unremarkable thought content. Tr. 568, 570.

After this visit, a nurse called Church back to discuss his medications. Tr. 540.

The nurse indicated that Church had cooperative behavior, clear speech,

logical thought process, and unremarkable thought content. Tr. 540–41.

In October 2022, Church saw Mates and reported that his mood was

“still up and down,” but “tolerable.” Tr. 575. He had some social anxiety when

he went out. 575. In December 2022, Church told Mates that he was “doing

ok”; he had good days and bad days but overall felt that his mediations “ke[pt]

him from the extremes.” Tr. 583. Mates continued Church’s medications. Tr.

588.

In February 2023, Church saw Lindo and advised that “due to counselor

turnover,” he had not had counseling for about six months. Tr. 834. Church

reported anxiety, depression, sleep disturbances, and a fair energy level. Tr.

834. He said that his mood had slightly improved. Tr. 834.

In August 2023, Church told Lindo that he was “doing better on meds”

that Mates prescribed. Tr. 845, 849. Church reported decreased paranoia,

improved ability to socialize, less rumination, and improved sleep. Tr. 845. He

“was in better spirits” and his relationship with his girlfriend had improved.

Tr. 845.

State agency opinions.3

In October 2022, Karla Delcour, Ph.D., reviewed Church’s record. Tr.

3 When a claimant applies for disability benefits, the State Agency creates

a record. The record includes the claimant’s medical evidence. A State Agency

disability examiner and a State Agency physician or psychologist review the

claimant’s record and determine whether and to what extent the claimant’s

condition affects his or her ability to work. If the State Agency denies the

claimant’s application, the claimant can ask for reconsideration. On

reconsideration, the State Agency updates the record and a second disability

examiner and doctor review the file and make a new determination. See, e.g.,

20 C.F.R. § 404.1615.

90–91. Regarding Church’s mental residual functional capacity (RFC),4 Dr.

Delcour adopted the RFC assessment of a different ALJ who had evaluated

Church’s prior disability application. Tr. 96. That RFC assessment limited

Church to “simple, routine, and repetitive tasks in a work environment free

from fast paced production requirements, such as moving assembly lines and

conveyor belts.” Tr. 91. Church could only make “work related decisions, with

few if any work place changes.” Tr. 91. He could have occasional interaction

with the general public, coworkers, and supervisors. Tr. 91. In March 2023,

Alvin Smith Ph.D., agreed with Dr. Delcour’s assessment. Tr. 112, 117.

Hearing testimony

Church, who was represented by counsel, testified at the telephonic

administrative hearing held in October 2023. Regarding his mental health

issues, Church stated that his worst problem was his racing thoughts and

anxiety. Tr. 51. At times, being around people was “unbearable.” Tr. 51.

Church takes medication for depression, anxiety, bipolar disorder, and

paranoia. Tr. 52. He feels like he doesn’t want to leave the house. Tr. 52. He

takes his dog for short walks. Tr. 53.

The ALJ discussed with the vocational expert Church’s past work as an

outside sales representative, service manager, motor vehicle assembler, and

4 An RFC is an “‘assessment of’” a claimant’s ability to work, taking his or

her “limitations … into account.” Howard v. Comm’r of Soc. Sec., 276 F.3d 235,

239 (6th Cir. 2002) (quoting 20 C.F.R. § 416.945). Essentially, it’s the SSA’s

“description of what the claimant ‘can and cannot do.’” Webb v. Comm’r of Soc.

Sec., 368 F.3d 629, 631 (6th Cir. 2004) (quoting Howard, 276 F.3d at 239).

appliance salesperson. Tr. 76. The ALJ asked the vocational expert to

determine whether a hypothetical individual such as Church could perform

Church’s past work or any other work if the individual had the limitations

assessed in the ALJ’s RFC determination, described below. Tr. 76–78. The

vocational expert answered that such an individual could not perform Church’s

past work, but could perform the following jobs: garment sorter, assembler,

and bagger. Tr. 77–78.

The ALJ’s Decision

The ALJ made the following findings of fact and conclusions of law:

1. The claimant meets the insured status

requirements of the Social Security Act through

December 31, 2023.

2. The claimant has not engaged in substantial

gainful activity since December 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: osteoarthritis; lumbar facet

arthropathy; cervicalgia; bipolar depression; and

anxiety (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, I

find that the claimant has the residual functional

capacity to perform light work as defined in 20 CFR

404.1567(b) and 416.967(b) except: occasional

overhead reaching, pushing or pulling, frequent

handling, fingering and feeling, no hand or foot

controls, no climbing ladders, ropes and scaffolds

and engaging in the remaining postural activities on

an occasional basis in environments with no

assembly line production dictated by an external

source, no dangerous machinery, no unprotected

elevations, no extreme temperatures and no

commercial driving with frequent interaction with

the public, co-workers and supervisors. In addition,

the claimant can understand, remember and carry

out simple instructions that require little or no

judgment and a short period of time to learn.

6. The claimant is unable to perform any past

relevant work (20 CFR 404.1565 and 416.965).

7. The claimant was … 50 years old, which is defined

as an individual closely approaching advanced age,

on the alleged disability onset date (20 CFR

404.1563 and 416.963).

8. The claimant has at least a high school education

(20 CFR 404.1564 and 416.964).

9. Transferability of job skills is not material to the

determination of disability because using the

Medical-Vocational Rules as a framework supports

a finding that the claimant is “not disabled,”

whether or not the claimant has transferable job

skills (See SSR 82-41 and 20 CFR Part 404, Subpart

P, Appendix 2).

10. Considering the claimant’s age, education, work

experience, and residual functional capacity, there

are jobs that exist in significant numbers in the

national economy that the claimant can perform (20

CFR 404.1569, 404.1569a, 416.969, and 416.969a).

11. The claimant has not been under a disability,

as defined in the Social Security Act, from December

28, 2021, through the date of this decision (20 CFR

404.1520(g) and 416.920(g)).

Tr. 20–34.

Standard for Disability

Eligibility for social security benefit payments depends on the existence

of a disability. 42 U.S.C. §§ 423(a), 1382(a). “Disability” is defined as the

“inability to engage in any substantial gainful activity by reason of any

medically determinable physical or mental impairment which can be expected

to result in death or which has lasted or can be expected to last for a continuous

period of not less than 12 months[.]” 42 U.S.C. § 423(d)(1)(A); see also 42 U.S.C.

§ 1382c(a)(3)(A).

An ALJ is required to follow a five-step sequential analysis to make a

disability determination:

1. Is the claimant engaged in substantial gainful

activity? If so, the claimant is not disabled.

2. Does the claimant have a medically

determinable impairment, or a combination of

impairments, that is “severe”? If not, the

claimant is not disabled.

3. Does the claimant’s impairment meet or equal

one of the listed impairments and meet the

duration requirement? If so, the claimant is

disabled. If not, the ALJ proceeds to the next

step.

4. What is the claimant’s residual functional

capacity and can the claimant perform past

relevant work? If so, the claimant is not

disabled. If not, the ALJ proceeds to the next

step.

5. Can the claimant do any other work

considering the claimant’s residual functional

capacity, age, education, and work

experience? If so, the claimant is not disabled.

If not, the claimant is disabled.

20 C.F.R. §§ 404.1520, 416.920. see Jordan v. Comm’r of Soc. Sec., 548 F.3d

417, 422 (6th Cir. 2008). Under this sequential analysis, the claimant has the

burden of proof at steps one through four. Jordan, 548 F.3d at 423. The burden

shifts to the Commissioner at step five “to prove the availability of jobs in the

national economy that the claimant is capable of performing.” Id. “The

claimant, however, retains the burden of proving her lack of residual functional

capacity.” Id. If a claimant satisfies each element of the analysis and meets the

duration requirements, the claimant is determined to be disabled. Walters

Comm’r of Soc. Sec., 127 F.3d 525, 529 (6th Cir. 1997).

Standard of review

A reviewing court must affirm the Commissioner’s conclusions unless it

determines “that the ALJ has failed to apply the correct legal standards or has

made findings of fact unsupported by substantial evidence in the record.”

Jordan, 548 F.3d at 422. “‘[S]ubstantial evidence’ is a ‘term of art’” under which

“a court … asks whether” the “existing administrative record … contains

‘sufficien[t] evidence’ to support the agency’s factual determinations.” Biestek

v. Berryhill, 587 U.S. 97, 102 (2019) (citations omitted). The substantial

evidence standard “is not high.” Id. at 103. Substantial evidence “is ‘more than

a mere scintilla’” but it “means only[] ‘such relevant evidence as a reasonable

mind might accept as adequate to support a conclusion.’” Id. (citations

omitted). The Commissioner’s “findings … as to any fact if supported by

substantial evidence [are] conclusive.” 42 U.S.C. § 405(g); Biestek, 587 U.S. at

99.

A court may “not try the case de novo, resolve conflicts in evidence, or

decide questions of credibility.” Bass v. McMahon, 499 F.3d 506, 509 (6th Cir.

2007). Even if substantial evidence or a preponderance of the evidence

supports a claimant’s position, a reviewing court cannot overturn the

Commissioner’s decision “so long as substantial evidence also supports the

conclusion reached by the ALJ.” Jones v. Comm’r of Soc. Sec., 336 F.3d 469,

477 (6th Cir. 2003). This is so because there is a “zone of choice within which”

the Commissioner can act, without fear of judicial “interference.” Lindsley v.

Comm’r of Soc. Sec., 560 F.3d 601, 605 (6th Cir. 2009) (quoting Felisky v.

Bowen, 35 F.3d 1027, 1035 (6th Cir. 1994)).

Discussion

1. The ALJ did not run afoul of the rule in Earley

Church argues that the ALJ applied the incorrect standard of review to

another ALJ’s decision on Church’s prior disability application. Doc. 8, at 10–

13.

In Drummond v. Commissioner of Social Security, 126 F.3d 837 (6th Cir.

1997), the Sixth Circuit said that certain previous cases “clearly demonstrate

that the principles of res judicata can be applied against the Commissioner.

When the Commissioner has made a final decision concerning a claimant’s

entitlement to benefits, the Commissioner is bound by this determination

absent changed circumstances.” Id. at 842. The Social Security Administration

adopted this ruling as Acquiescence Ruling 98-4(6). See SSAR 98-4(6), 63 FR

29771-01, 1998 WL 274052 (June 1, 1998).

But in Earley v. Commissioner of Social Security, 893 F.3d 929 (6th Cir.

2018), the Sixth Circuit said that “[w]hen an individual seeks disability

benefits for a distinct period of time, each application is entitled to review.

There is nothing in the relevant statutes to the contrary. And res judicata only

‘foreclose[s] successive litigation of the very same claim.’” Id. at 933 (“a claim

that one became disabled in 1990 is not the same as a claim that one became

disabled in 1994.”). The Social Security Administration rescinded Acquiescence

Ruling 98-4(6) and replaced it with Acquiescence Ruling 24-1(6), effective

December 2, 2024, to reflect the Sixth Circuit’s Earley decision. See SSAR 24-

1(6), 89 FR 92992, 2024 WL 5256889 (Nov. 25, 2024).

Church’s claim covers December 28, 2021 to February 26, 2024. Tr. 34–

45. This is a distinct period of time from that of Church’s previous claim, which

covered the time up to February 2, 2021. Tr. 17. So Church’s current

application is entitled to a “fresh look.” See Dennis D. v. Comm’r of Soc. Sec.,

No. 23-3667, 2024 WL 1193662, at *4 (6th Cir. Mar. 20, 2024) (quoting Earley,

893 F.3d at 931).

At the outset of her decision, the ALJ stated that she was “bound by the

previous findings and determinations, … unless there is new and material

evidence or a showing of ‘changed circumstances’ relating to a determination

of the present claim in accordance with Acquiescence Rulings 98-3(6) and 98-

4(6).” Tr. 18. At each step of the sequential evaluation, the ALJ evaluated the

record, found that it showed that Church’s condition had changed since his

prior disability application, and expressly stated that “AR 98-4(6) does not

apply to this finding.” Tr. 20 (step two), Tr. 21 (step three), Tr. 23 (RFC

determination). So the ALJ evaluated the evidence and gave it a “fresh look,”

thereby conforming to the ruling in Earley. See Dennis D., 2024 WL 1193662,

at *4–6 (finding that despite the ALJ’s “inaccurate recitation of the legal effect

of the prior determination” that he was bound by the prior ALJ’s decision, the

ALJ conducted his own review of the evidence and, therefore, conformed to the

rule in Earley).

Church complains that the Appeals Council “should have reviewed the

ALJ’s decision and determined whether the ALJ complied with AR 24-1(6),”

which was in effect when the Appeals Council considered Church’s request for

review. Doc. 8, at 11–12. But this Court reviews the ALJ’s decision, not the

Appeals Council’s decision to deny review.5 See Casey v. Sec’y of Health &

Human Servs., 987 F.2d 1230, 1233 (6th Cir. 1993).

Finally, Church points out that the state agency reviewers adopted the

prior ALJ’s RFC. Doc. 8, at 11; Doc. 11, at 1; see Tr. 91, 97, 101–02, 107. And

5 Also, the Commissioner points out that the Agency’s “Hearings, Appeals,

and Litigation Law Manual (HALLEX) …. makes clear [that] the Appeals

Council ‘will not grant review of a properly issued hearing decision dated prior

to December 2, 2024 solely to apply the Earley AR.’” Doc. 10, at 7 (quoting

HALLEX § 01540.075).

because the ALJ “credited” these opinions, Church claims, the ALJ erred. Id.

But the ALJ acknowledged that the state agency reviewers adopted the prior

ALJ’s RFC. Tr. 31. The ALJ then recited every limitation the reviewers

adopted; discussed evidence during the relevant period; explained why she

found portions of the reviewers’ opinions to be not persuasive, somewhat

persuasive, or generally persuasive; and stated why she modified the

reviewers’ assessed limitations to fit the RFC that she assessed. Tr. 32. In other

words, the ALJ gave a “fresh look” at the state agency reviewers’ opinions and

the evidence, explained her findings, and crafted a different RFC. This was not

error. See also Dennis D., 2024 WL 1193662, at *6 (an ALJ does not err even

when he or she uses the prior ALJ’s RFC as a starting point for a new RFC

assessment).

2. The ALJ erred when evaluating Nurse Mates’s opinion

Church argues that the ALJ erred when evaluating Nurse Mates’s

opinion. Doc. 8, at 13–21.

The Commissioner is required to evaluate the persuasiveness of all

medical opinions using the following factors: supportability; consistency;

treatment relationship, including the length, frequency, purpose, and extent;

specialization; and other factors. 20 C.F.R. §§ 416.920c(a), 416.920c(c)(1)–(5).

Supportability and consistency are the most important factors. 20 C.F.R. §

416.920c(a). Supportability means 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[] … the more persuasive the medical

opinions … will be.” 20 C.F.R. § 416.920c(c)(1). Consistency means “[t]he more

consistent a medical opinion[] … is with the evidence from other medical

sources and nonmedical sources in the claim, the more persuasive the medical

opinion[] … will be.” 20 C.F.R. § 416.920c(c)(2). The Commissioner must

explain the supportability and consistency factors when discussing a medical

opinion. 20 C.F.R. § 416.920c(b)(2). The Commissioner is not required to

discuss the remaining factors. 20 C.F.R. § 416.920c(b)(2)).

The ALJ discussed and evaluated Mates’s opinion as follows:

I considered the opinion of Steven Mates, psychiatric

mental health board certified nurse practitioner

(PMHNP-BC), the claimant’s mental health

provider (Exhibit B2F/1-2). Mr. Mates stated the

claimant had moderate difficulties in maintaining

concentration, persistence or pace while none to mild

difficulties understanding, remembering or applying

information, interacting with others and adapting or

managing oneself, but he would be absent from work

two days a month on average (Exhibit B2F/1). Mr.

Mates also provided the claimant would have

moderate limitations in his ability to complete an

eight-hour workday and workweek without

interruptions from psychologically based symptoms

and to perform a consistent pace without an

unreasonable number and length of rest periods

while he would have mild limitations in his ability

to remember locations and work-like procedures, get

along with coworkers or peers without distracting

them or exhibiting behavioral extremes and

responding appropriately to change in the work

setting and no limitation carrying out very short and

simple instructions (Exhibit B2F/2).

I find [the] opinion by Mr. Mates is somewhat

persuasive. The opinion by Mr. Mates that the

claimant would be absent from work two days a

month on average does not appear internally

consistent with the other opinions by Mr. Mates that

the claimant had only mild to moderate limitations

in the claimant’s work abilities (Exhibit B2F/1-2).

Mr. Mates also noted that the claimant had no

medication adjustments for six months when

contemplating the opinion, which appears to support

the opinions by Mr. Mates that the claimant had

simply mild to moderate limitations in the areas of

completing an eight-hour workday and workweek,

remember locations and work-like procedures,

maintaining concentration, persistence or pace,

understanding, remembering or applying

information, interacting with others, adapting or

managing oneself and responding to change in the

work setting (Exhibit B2F/2). The mild to moderate

limitations contemplated in those areas also appear

consistent with the claimant’s own statements to his

treating providers that his mental health symptoms

were better since attending specialized mental

health treatment and/or his symptoms were

tolerable (Exhibits B4F/11, 14, B5F/36, 44, B6F/182,

189, 197 and B7F/2). As such, I find the opinion

regarding absenteeism by Mr. Mates is not

persuasive, but the rest of the opinion is persuasive

and those parts were considered in determining the

residual functional capacity herein.

Tr. 31.

Church first asserts that the ALJ “failed to compare [] Mates’ opinion to

the mental status examinations in the record” and to the state agency

reviewers’ opinions. Doc. 8, at 13, 20. But Church doesn’t identify legal

authority requiring an ALJ to articulate a comparison of an opinion to a

particular piece of evidence in the record. See also Sallaz v. Comm’r of Soc.

Sec., No. 23-3825, 2024 WL 2955645, at *6 (6th Cir. June 12, 2024) (“Sallaz

identifies no authority limiting ALJs to relying on a rebuttal medical opinion

when [evaluating the persuasiveness of opinion evidence]”).

Church’s main argument fares better. Church contends that, contrary

to the ALJ’s statement, Mates’s finding that Church would be absent two days

a month was not inconsistent with Mates’s finding that Church had “moderate

limitations in his ability to complete an eight-hour 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.”6

Doc. 8, at 15; Doc. 11, at 2–3. Church points out that the form Mates completed

invited him to select how many days a month Church would be absent from

work, and provided six options: “none,” “one,” “two,” “three,” “four,” and “four

or more.” Tr. 490; Doc. 11, at 2–3. Mates selected “two.” Tr. 490. This option

straddles the lower end of the halfway point between none and four or more—

the middle, so to speak. And Mates found that Church had “moderate”

limitations “complet[ing] an eight-hour workday and workweek without

interruptions from psychologically based symptoms,” Tr. 491, a limitation that

the ALJ found persuasive, Tr. 31. The form doesn’t define moderate, but this

word is generally accepted to mean average. See Moderate, Merriam-Webster

6 I note that the form asked Mates to assess Church’s “ability to complete

a[n] 8-hour work-day and workweek without interruptions from

psychologically based symptoms and to perform a consistent pace without an

unreasonable number and length of rest periods.” Tr. 491(emphasis added).

This is a compound sentence. It’s not therefore clear whether Mates was

offering an opinion on the first part of this sentence, the second part, or both.

The ALJ apparently assumed it was both. Tr. 31.

Online Dictionary, https://www.merriam-webster.com/dictionary/moderate

(last visited Aug. 20, 2025). So the ALJ’s finding that Mates’s absent-two-days-

a-month opinion was internally inconsistent with Mates’s opinion that Church

had moderate limitations “complet[ing] an eight-hour workday and workweek

without interruptions from psychologically based symptoms,” Tr. 31, is not

supported.7 Indeed, it is the ALJ’s explanation that is internally inconsistent.

I therefore recommend that the ALJ’s decision be remanded.8 See

Jordan, 548 F.3d at 422 (remand is appropriate when the ALJ’s “findings of

fact [are] unsupported by substantial evidence in the record”).

Conclusion

For the reasons explained above, I recommend that the Court vacate and

remand the Commissioner’s decision for proceedings consistent with this

opinion.

Dated: August 20, 2025

/s/ James E. Grimes Jr.

James E. Grimes Jr.

U.S. Magistrate Judge

7 The Commissioner offers an alternative explanation for rejecting

Mates’s absenteeism opinion. Doc. 10, at 9. But the ALJ did not provide this

explanation, so it can’t serve as a basis to affirm the ALJ’s decision. See Hicks

v. Comm’r of Soc. Sec., 909 F.3d 786, 808 (6th Cir. 2018) (“[A]n agency’s actions

must be upheld, if at all, on the basis articulated by the agency itself, and not

based on appellate counsel’s post hoc rationalization[s]”) (internal quotation

marks and citations omitted).

8 Because I recommend the Court find that remand is appropriate on this

issue, I don’t consider Church’s final argument that the ALJ erred when

evaluating the state agency reviewers’ opinions, Doc. 8, at 21–25.

OBJECTIONS

Any objections to this Report and Recommendation must be filed with

the Clerk of Court within 14 days after the party objecting has been served

with a copy of this Report and Recommendation. 28 U.S.C. § 636(b)(1). Failure

to file objections within the specified time may forfeit the right to appeal the

District Court’s order. See Berkshire v. Beauvais, 928 F.3d 520, 530–31 (6th

Cir. 2019).