Jones

UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF ALABAMA

MIDDLE DIVISION

ANNETTE JONES, )

)

Plaintiff, )

)

v. ) Case No.: 4:25-cv-120-AMM

)

SOCIAL SECURITY )

ADMINISTRATION, )

Commissioner, )

)

Defendant. )

MEMORANDUM OF DECISION

Plaintiff Annette Jones brings this action pursuant to the Social Security Act

(the “Act”), seeking review of the decision of the Commissioner of Social Security

(“Commissioner”) denying her claim for a period of disability and disability

insurance benefits (“benefits”). See 42 U.S.C. § 405(g). Based on the court’s review

of the record, the court AFFIRMS the decision of the Commissioner.

I. Introduction

On September 8, 2021, Ms. Jones protectively filed an application for benefits

under Title II of the Act, alleging disability beginning August 15, 2021. R. 17, 87–

99, 267–76. Ms. Jones alleges disability due to: blind or low vision, fibromyalgia,

bipolar, anxiety, and mood disorder. R. 87.

The Social Security Administration (“SSA”) initially denied Ms. Jones’s

application on July 21, 2022, and again upon reconsideration on April 27, 2023. R.

17, 86–111. On June 26, 2023, Ms. Jones filed a request for a hearing before an

Administrative Law Judge (“ALJ”). R. 17, 132–33. That request was granted. R.

185–89. Ms. Jones received a telephone hearing before ALJ Clarence Guthrie on

January 2, 2024. R. 17, 49–85. On March 20, 2024, ALJ Guthrie issued a decision,

finding that Ms. Jones was not disabled from August 15, 2021, through the date of

the decision. R. 14–42. Ms. Jones was forty-three years old at the time of the ALJ

decision. R. 40, 42.

Ms. Jones appealed to the Appeals Council, which denied her request for

review on November 26, 2024. R. 1–3. After the Appeals Council denied Ms.

Jones’s request for review, R. 1–3, the ALJ’s decision became the final decision of

the Commissioner and subject to district court review. On January 23, 2025, Ms.

Jones sought this court’s review of the ALJ’s decision. See Doc. 1.

II. The ALJ’s Decision

The Act establishes a five-step test for the ALJ to determine disability. 20

C.F.R. § 404.1520. First, the ALJ must determine whether the claimant is engaging

in substantial gainful activity. 20 C.F.R. § 404.1520(a)(4)(i). “Substantial work

activity is work activity that involves doing significant physical or mental activities.”

20 C.F.R. § 404.1572(a). “Gainful work activity” is work that is done “for pay or

profit.” 20 C.F.R. § 404.1572(b). If the ALJ finds that the claimant engages in

substantial gainful activity, then the claimant cannot claim disability. 20 C.F.R. §

404.1520(b). Second, the ALJ must determine whether the claimant has a medically

determinable impairment or a combination of medical impairments that significantly

limits the claimant’s ability to perform basic work activities. 20 C.F.R. §

404.1520(a)(4)(ii), (c). Absent such impairment, the claimant may not claim

disability. 20 C.F.R. § 404.1520(a)(4)(ii), (c). Third, the ALJ must determine

whether the claimant’s impairment meets or medically equals the criteria of an

impairment listed in 20 C.F.R. § 404, Subpart P, Appendix 1. See 20 C.F.R. §§

404.1520(a)(4)(iii), 404.1520(d), 404.1525, 404.1526. If such criteria are met, the

claimant is declared disabled. 20 C.F.R. § 404.1520(a)(4)(iii).

If the claimant does not fulfill the requirements necessary to be declared

disabled under the third step, the ALJ still may find disability under the next two

steps of the analysis. The ALJ must first determine the claimant’s residual functional

capacity, which refers to the claimant’s ability to work despite her impairments. 20

C.F.R. §§ 404.1520(e), 404.1545. In the fourth step, the ALJ determines whether the

claimant has the residual functional capacity to perform past relevant work. 20

C.F.R. § 404.1520(a)(4)(iv). If the ALJ determines that the claimant is capable of

performing past relevant work, then the claimant is deemed not disabled. 20 C.F.R.

§ 404.1520(a)(4)(iv). If the ALJ finds the claimant unable to perform past relevant

work, then the analysis proceeds to the fifth and final step. 20 C.F.R. §

404.1520(a)(4)(v). In this step, the ALJ must determine whether the claimant is able

to perform any other work commensurate with her residual functional capacity, age,

education, and work experience. 20 C.F.R. § 404.1520(g)(1). Here, the burden of

proof shifts from the claimant to the Commissioner to prove the existence, in

significant numbers, of jobs in the national economy that the claimant can do given

her residual functional capacity, age, education, and work experience. 20 C.F.R. §§

404.1520(g)(1), 404.1560(c).

The ALJ determined that Ms. Jones would meet the insured status

requirements of the Act through December 31, 2024. R. 18, 19. Next, the ALJ found

that Ms. Jones “has not engaged in substantial gainful activity since August 15, 2021,

the alleged onset date.” R. 19 (emphasis omitted). The ALJ decided that Ms. Jones

had the following severe impairments: obesity, degenerative disc disease,

fibromyalgia, loss of central visual acuity, depression, bipolar disorder, anxiety

disorder, and amphetamine use disorder. R. 20. The ALJ found that Ms. Jones had

these “non-severe” impairments that “have no more than a minimal effect on [her]

ability to meet the basic demands of work activity”: hypertension, hyperlipidemia,

asthma, allergic rhinitis, and diabetes mellitus. R. 20. Overall, the ALJ determined

that Ms. Jones “does not have an impairment or combination of impairments that

meets or medically equals the severity of one of the listed impairments” to support

a finding of disability. R. 22 (emphasis omitted).

The ALJ found that Ms. Jones’s “statements concerning the intensity,

persistence[,] and limiting effects of these symptoms are not entirely consistent with

the medical evidence and other evidence in the record.” R. 28. The ALJ found that

Ms. Jones “has the residual functional capacity to perform light work” with certain

limitations. R. 27 (emphasis omitted). The ALJ determined that Ms. Jones can:

frequently stoop; occasionally kneel, crouch, or crawl; occasionally be exposed to

extreme cold, extreme heat, excessive irritants, poorly ventilated areas, and

chemicals; and avoid ordinary hazards in the workplace. R. 27. The ALJ determined

that Ms. Jones cannot: climb ladders, ropes, or scaffolds; or be exposed to workplace

hazards such as moving mechanical parts and high, exposed places. R. 27. The ALJ

determined that Ms. Jones can understand, remember, and carry out detailed, but not

complex instructions; cannot perform work requiring a specific production rate, such

as assembly line work or work that requires hourly quotas; can tolerate occasional

interaction with the public and occasional interaction with co-workers and

supervisors; and can deal with occasional changes in the work setting. R. 27.

The ALJ determined that Ms. Jones’s past relevant work was that of a certified

nurse assistant, cloth winder, and label coder. R. 39. The ALJ determined Ms. Jones

is “unable to perform any past relevant work.” R. 39 (emphasis omitted).

According to the ALJ, Ms. Jones is “a younger individual” and has “at least a

high school education,” as those terms are defined by the regulations. R. 40

(emphasis omitted). The ALJ determined that “[t]ransferability of job skills is not

material to the determination of disability” in this case. R. 40 (emphasis omitted).

Because Ms. Jones’s “ability to perform all or substantially all of the requirements

of this level of work has been impeded by additional limitations,” the ALJ enlisted

a vocational expert to ascertain whether there were a significant number of jobs in

the national economy that Ms. Jones could perform. R. 41. That expert concluded

that there were indeed a significant number of such jobs in the national economy,

such as a cleaner, housekeeping and a garment sorter. R. 41.

Based on these findings, the ALJ concluded that Ms. Jones was not under a

disability as defined in the Act, from August 15, 2021, through March 20, 2024, the

date of the decision. R. 41–42. Ms. Jones now challenges that decision.

III. Standard of Review

This court’s role in reviewing claims brought under the Act is a narrow one.

The only issues before this court are whether the record reveals substantial evidence

to sustain the ALJ’s decision and whether the correct legal standards were applied.

See 42 U.S.C. § 405(g); Walker v. Soc. Sec. Admin, Comm’r, 987 F.3d 1333, 1338

(11th Cir. 2021); Lamb v. Bowen, 847 F.2d 698, 701 (11th Cir. 1988); Chester v.

Bowen, 792 F.2d 129, 131 (11th Cir. 1986). The Act mandates that the

Commissioner’s findings are conclusive if supported by “substantial evidence.”

Martin v. Sullivan, 894 F.2d 1520, 1529 (11th Cir. 1990); see 42 U.S.C. § 405(g).

This court may not reconsider the facts, reevaluate the evidence, or substitute its

judgment for that of the Commissioner; instead, it must review the record as a whole

and determine if the decision “is reasonable and supported by substantial evidence.”

See Martin, 894 F.2d at 1529 (quoting Bloodsworth v. Heckler, 703 F.2d 1233, 1239

(11th Cir. 1983)).

Substantial evidence falls somewhere between a scintilla and a preponderance

of evidence; “[i]t is such relevant evidence as a reasonable person would accept as

adequate to support a conclusion.” Id. (quoting Bloodsworth, 703 F.2d at 1239). If

the Commissioner’s factual findings are supported by substantial evidence, they

must be affirmed even if the preponderance of the evidence is against the

Commissioner’s findings. Id. No decision is automatic, for “[d]espite th[e]

deferential standard [for review of claims], it is imperative that th[is] Court

scrutinize the record in its entirety to determine the reasonableness of the decision

reached.” Bridges v. Bowen, 815 F.2d 622, 624 (11th Cir. 1987) (citing Arnold v.

Heckler, 732 F.2d 881, 883 (11th Cir. 1984)). Failure to apply the correct legal

standards is grounds for reversal. See Bowen v. Heckler, 748 F.2d 629, 635 (11th

Cir. 1984).

IV. Discussion

Ms. Jones raises five arguments on appeal. First, Ms. Jones argues that “[t]he

ALJ failed to properly evaluate the medical opinion evidence.” Doc. 11 at 2. Second,

Ms. Jones argues that the ALJ’s residual functional capacity determination was not

properly supported. Id. at 8. Third, Ms. Jones argues that “the ALJ erred by failing

to reconcile an apparent conflict between the Dictionary of Occupational Titles . . .

and the testimony of the vocational expert . . . regarding the jobs found for [Ms.

Jones] at step five.” Id. at 10 (emphasis omitted). Fourth, Ms. Jones argues that

“[t]he ALJ relied on a flawed hypothetical question to the vocational expert.” Id. at

2. Fifth, Ms. Jones argues that “[t]he ALJ failed to properly evaluate [her] subjective

statements.” Id.

A. The ALJ’s Evaluation of Ms. Jones’s Medical Opinion Evidence

The SSA has revised the applicable regulations related to medical opinion

evidence. The SSA’s new regulations, promulgated in 2017, do away with the

hierarchy of medical opinions and the treating source rule. 20 C.F.R. § 404.1520c(a).

Under the new regulations, an ALJ need not “defer or give any specific evidentiary

weight, including controlling weight, to any medical opinion(s)” for all claims filed

on or after March 27, 2017. Id. And the ALJ “will articulate in [his] determination

or decision how persuasive [he] find[s] all of the medical opinions . . . in [the

claimant’s] case record.” Id. § 404.1520c(b).

When evaluating the persuasiveness of the opinions, the ALJ considers these

factors: (1) supportability, i.e., how “relevant the objective medical evidence and

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

medical opinion(s)”; (2) consistency with the evidence; (3) relationship with the

claimant, including the nature of the relationship, the length of the treatment

relationship, the frequency of examinations, and the purpose and extent of the

treatment relationship; (4) specialization; and (5) “[o]ther factors,” such as the

medical source’s familiarity with the agency’s policies and the evidence in the claim.

Id. § 404.1520c(c). Supportability and consistency are the most important of the five

factors. Id. § 404.1520c(b)(2). Supportability measures how a medical source

presents “objective medical evidence and supporting explanations” “to support his

or her medical opinion(s).” Id. § 404.1520c(c)(1). Consistency measures how a

medical opinion compares to “evidence from other medical sources and nonmedical

sources in the claim.” Id. § 404.1520c(c)(2). An ALJ must “explain how [he]

considered the supportability and consistency factors for a medical source’s medical

opinions . . . in [his] . . . decision.” Id. § 404.1520c(b)(2). The ALJ may explain how

he considered the remaining factors, but he is not required to do so. Id. The ALJ is

not required to use “magic words” or follow a particular formula to articulate his

consideration of the factors. See id. § 404.1520c; Thaxton v. Kijakazi, No. 1:20-cv-

00616-SRW, 2022 WL 983156, at *8 (M.D. Ala. Mar. 30, 2022).

Ms. Jones argues that the ALJ failed to accord proper weight to an August 22,

2023, Clinical Assessment of Pain report and Medical Questionnaire Regarding

Limitations completed by Ivonne Joiner, C.R.N.P. Doc. 11 at 3; see also R. 976–77.

In the Clinical Assessment of Pain, N.P. Joiner made the following selections

regarding her assessment of Ms. Jones’s pain:

Question: “To what extent is pain of significance in the

treatment of this patient?”

Selected Response: “Pain is present to such an extent as to

be distracting to adequate performance of daily activities

or work.”

Question: “To what extent will physical activity, such as

walking, standing, sitting, bending, stooping, moving of

extremities, etc., increase the degree of pain experienced

by this patient?”

Selected Response: “Greatly increased pain and to such a

degree as to cause distraction from tasks or total

abandonment of task.”

Question: “In your best judgment, to what extent will the

side effects of prescribed medications impact upon this

patient’s ability to perform his/her work?”

Selected Response: “Should be able to perform job duties

without any decrease in work effectiveness.”

R. 976.

In the Medical Questionnaire Regarding Limitations, N.P. Joiner opined that

Ms. Jones’s “medical conditions preclude her ability to maintain concentration,

persistence, and pace for two-hour periods.” R. 977. N.P. Joiner also opined that Ms.

Jones’s “medical conditions preclude her ability to perform activities within a

schedule, maintain regular attendance and be punctual within customary tolerances

on a continuous basis.” R. 977. N.P. Joiner affirmed that Ms. Jones’s “medical

conditions require her to lie down during the day” and explained that “[s]ometimes

patient needs to lie down to alleviate pain.” R. 977. N.P. Joiner assessed that, in an

eight-hour workday, Ms. Jones could:

• Sit for one hour;

• Stand or walk for zero hours.

R. 977. However, next to this assessment, N.P. Joiner wrote “N/A patient does not

work.” R. 977. Likewise, N.P. Joiner did not answer how many days per month Ms.

Jones was “likely to be absent from work as a result of the impairments” and instead

wrote “N/A pt does not work.” R. 977. Finally, N.P. Joiner did not include any

additional comments. R. 977.

The ALJ considered and discussed N.P. Joiner’s medical opinion in his

residual functional capacity findings:

Ivonne R. Joiner, CRNP, provided a statement indicating

that the claimant’s pain is present to such extent that it is

distracting to adequate performance of daily activities or

work; her pain is increased to the extent that it causes off

task behavior;[] but she should be able to perform job

duties without any decrease in work effectiveness. Ms.

Joiner also noted that the claimant can maintain

concentration, persistence, and pace for 2-hour periods;

her medical conditions preclude her ability to perform

activities within a schedule[], maintain regular attendance,

and be punctual within customary tolerances on a

continuous basis; she has medical conditions that require

her to lie down during the day such as pain. Ms. Joiner also

noted that the claimant can sit for a total of 1 hour in an 8-

hour workday and stand and/or walk for 0 hours in an 8-

hour workday but noted that these were not applicable

because the claimant is not working. I am not persuaded

by this statement, as it is not fully supported by her

examination findings after only two visits. It is not until

she established primary care with Ms. Joiner after her

accident that she had abnormal physical findings such as

tenderness and limited range of motion of the cervical and

lumbar spine, positive straight leg raise testing, irregular

gait with stiff ambulation, but she had intact sensation

throughout. Additionally, Ms. Joiner provided conflicting

statements regarding distractibility and off task behavior,

as she first noted that it would cause off task behavior, but

noted that the claimant would be able to perform duties

without any decrease in work effectiveness.

Ms. Joiner’s statement is also inconsistent with the

evidence of record such as orthopedic records that show

that the claimant reported significant improvement of her

symptoms of neck, back, and right shoulder pain, with

physical findings demonstrating her reported

improvement. Even though pain management records

show decreased range of motion and tenderness of the

cervical, thoracic, and lumbar spine, the claimant had full

strength of all extremities, full range of motion of all other

joints, normal gait, intact sensation, and normal reflexes.

Finally, good cause exists to discount the opinion of Nurse

Joiner because this opinion consists of a series of checked

boxes on a form, devoid of detail with virtually no

explanation, and clearly contradicted by her

contemporaneous treatment records.

R. 36 (citations omitted).

Ms. Jones argues that “[t]he ALJ erred by criticizing N.P. Joiner’s opinions

as a ‘series of checked boxes on a form, devoid of detail with virtually no

explanation, and clearly contradicted by her contemporaneous treatment records.’”

Doc. 11 at 4 (quoting R. 36). Additionally, Ms. Jones argues that the ALJ erred by

“fail[ing] to explain why th[e] supportive explanation”—chronic pain—“did not

support the opinions in violation of 20 C.F.R. § 404.1520c(c)(1).” Doc. 11 at 5. Ms.

Jones also argues that “[t]he ALJ erred by failing to compare the opinions of N.P.

Joiner with . . . significant objective and clinical abnormalities in violation of the

Regulations at 20 C.F.R. § 404.1520c(c)(2).” Doc. 11 at 6. Ms. Jones argues that

“[t]he ALJ also erred by finding the opinions from N.P. Joiner internally

inconsistent” by “ignor[ing] the context of these responses.” Id. at 6–7. Finally, Ms.

Jones argues that “the ALJ improperly discounted the opinions from N.P. Joiner

because Ms. Jones had some response to treatment.” Id. at 7.

The Commissioner argues that “the ALJ properly evaluated the medical

opinion of Ms. Joiner, which was so limited in explanation that the ALJ had no basis

to accept the limitations opined upon.” Doc. 15 at 8. The Commissioner argues that

“[t]he ALJ’s analysis adhered to the regulations” and “applied the most important

factors of supportability and consistency.” Id. at 8, 10.

As an initial matter, the ALJ “considered th[is] medical opinion[] . . . in

accordance with the requirements of 20 CFR 404.1520c.” R. 27. Additionally, he

stated: “I fully considered the medical opinions . . . in accordance with 20 CFR

404.1520c but because I have the benefit of the entirety of the claimant’s medical

records and the additional testimony and evidence presented at the hearing, I rarely

find opinions to be simply ‘persuasive’ or ‘not persuasive,’ either accepting them

word-for-word or rejecting them altogether.” R. 34. The ALJ articulated how

persuasive he found the opinion, as required by the regulations. R. 36 (“I am not

persuaded by this statement . . . .”); see 20 C.F.R. § 404.1520c(b). The ALJ also

articulated how consistent he found the opinion, as required by the regulations. R.

36 (“Ms. Joiner’s statement is also inconsistent with the evidence of record . . . .”);

see 20 C.F.R. § 404.1520c(b).

The ALJ applied the correct legal standards in evaluating N.P. Joiner’s

opinion, and substantial evidence supports his finding that it was not persuasive

because “it is not fully supported by her examination findings after only two visits”

and is “clearly contradicted by her contemporaneous treatment records.” See R. 36.

In assessing supportability, the ALJ contrasted N.P. Joiner’s care before and after

Ms. Jones’s accident, noting that it was not until after Ms. Jones’s accident “that she

had abnormal physical findings.” R. 36. Additionally, the ALJ referenced N.P.

Joiner’s “conflicting statements regarding distractibility and off task behavior.” R.

36. In assessing consistency, the ALJ referenced Ms. Jones’s orthopedic records and

pain management records. R. 36. Specifically, the ALJ noted that the orthopedic

records show that Ms. Jones “reported significant improvement of her symptoms of

neck, back, and right shoulder pain, with physical findings demonstrating her

reported improvement.” R. 36. And the ALJ noted that although “pain management

records show decreased range of motion and tenderness of the cervical, thoracic, and

lumbar spine, [Ms. Jones] had full strength of all extremities, full range of motion of

all other joints, normal gait, intact sensation, and normal reflexes.” R. 36. Finally,

the ALJ opined that N.P. Joiner’s “opinion consists of a series of checked boxes on

a form, devoid of detail with virtually no explanation.” R. 36.

Before the ALJ made this finding with respect to N.P. Joiner’s medical

opinion, the ALJ detailed Ms. Jones’s hearing testimony, history of back pain,

findings from a physical consultative examination, primary care records, diagnostic

testing, orthopedic records, pain management records. R. 28–33. In making this

finding, the ALJ detailed Ms. Jones’s medical treatment including her visits to: N.P.

Joiner at Southside Medical Clinic, see R. 30, 1180–94; Ortho Sports Associates,

see R. 30, 1159–78; and Alabama Anesthesiology and Pain Management, see R. 30–

31, 1112–38, 1217–46. Ms. Jones presented to N.P. Joiner on May 2, 2023 to

establish care. R. 1184–86. At the visit, Ms. Jones reported her involvement in an

April 2023 motor vehicle accident, which resulted in neck pain, headache, back pain,

shoulder pain, and lower extremity pain. R. 1186. The physical examination revealed

tenderness, pain with motion, and muscle rigidity in her neck; abnormal motor

strength; tenderness; limited range of motion; positive straight leg test; irregular gait;

and stiffness with ambulation. R. 1187. N.P. Joiner directed Ms. Jones to return to

the clinic as needed. R. 1188. Ms. Jones presented to N.P. Joiner on July 5, 2023

complaining of “back pain” that had “been going on since 05/02/2023.” R. 1180.

Mr. Jones reported that since she was involved in a motor vehicle accident, she “has

had no improvement in lower back pain” despite orthopedic care and physical

therapy. R. 1182. The physical examination revealed “normal tone and motor

strength,” “no contractures, malalignment, or bony abnormalities,” but tenderness,

“pain to lower back upon hip and knee flexion,” and edema. R. 1183. N.P. Joiner

directed Ms. Jones to return to the clinic as needed. R. 1183. N.P. Joiner’s medical

records include imaging results, which the ALJ detailed in his residual functional

capacity finding. See R. 30, 1189–94.

Under the new regulations, the ALJ adequately accounted for his finding

regarding N.P. Joiner’s medical opinion. The ALJ’s decision reflects that he

considered N.P. Joiner’s own examination findings in his analysis. R. 30. The ALJ

expressly discussed and considered N.P. Joiner’s “abnormal physical findings” as

well as the imaging results included in her records. R. 30. The ALJ specifically

discussed the timing of Ms. Jones’s visits to N.P. Joiner in conjunction with her

injuries suffered in a motor vehicle accident. R. 36. Additionally, the ALJ cited other

medical evidence in the record that was inconsistent with N.P. Joiner’s medical

opinion. See R. 30–31. Thus, the ALJ properly addressed both the supportability and

consistency factors.

To the extent Ms. Jones criticizes the ALJ’s statement regarding the “checked

boxes” on the medical opinion form, the ALJ did not err: he did not solely remark

on the nature of the form but rather opined that the nature of the form coupled with

N.P. Joiner’s lack of written explanations or additional comments, the medical

opinion was “devoid of detail with virtually no explanation.” See R. 36.

The ALJ thoroughly explained the medical records regarding chronic pain.

See R. 29 (“She also reported compliance with medications such as for fibromyalgia

with reports of effectiveness and no adverse side effects.”); R. 30 (“Orthopedic

progress notes after completion of physical therapy show that she improved and had

no major complaints with no abnormal physical findings on examination.”) (citation

omitted); R. 30 (reflecting that pain management records show “up to 40% reduction

in pain with medications, improved sleep, and overall pain management goals met”)

(citation omitted). The ALJ summarized the medical finding both before and after

Ms. Jones’s motor vehicle accident and noted “significant improvement,”

“completing physical therapy,” and “some improvement with treatment,” while still

recognizing “abnormal physical findings regarding tenderness and decreased range

of motion” before finding that she could perform work at a light exertion. R. 33.

With respect to Ms. Jones’s criticism of the ALJ’s comment regarding off-

task behavior, there is no error. First, this is one data point of many upon which the

ALJ based his persuasiveness determination. Second, the record reflects that Ms.

Jones was treated with medication for pain, see R. 29–30, and that it was effective

without the hinderance of side effects. Thus, N.P. Joiner’s statement that pain would

cause off-task behavior is inconsistent with the record.

Finally, the ALJ did not discount the opinion of N.P. Joiner because Ms. Jones

had “some response to treatment.” See Doc. 11 at 7. Rather, the ALJ properly placed

N.P. Joiner’s treatment and examination of Ms. Jones in context to her motor vehicle

accident, orthopedic treatment (including completed physical therapy), and pain

management treatment.

The ALJ applied the correct legal standards in evaluating N.P. Joiner’s

opinion, and substantial evidence supports his finding that it was not persuasive. Ms.

Jones has not shown that the ALJ erred in her consideration of the medical opinion

evidence.

B. The ALJ’s Residual Functional Capacity Determination

Social Security Ruling 96-8p (“SSR 96-8p”) regulates the ALJ’s assessment

of a claimant’s residual functional capacity. Under SSR 96-8p, the residual

functional capacity “assessment must first identify the individual’s functional

limitations or restrictions and assess his or her work-related abilities on a function-

by-function basis.” SSR 96-8p at *1, 1996 WL 374184 (July 2, 1996). The ruling

specifically mandates a narrative discussion of “the individual’s ability to perform

sustained work activities in an ordinary work setting on a regular and continuing

basis . . . and describe the maximum amount of each work-related activity the

individual can perform based on the evidence available in the case record.” Id. at *7.

Additionally, in cases where symptoms are alleged, the assessment of a claimant’s

residual functional capacity must: “Contain a thorough discussion and analysis of

the objective medical and other evidence . . . ; Include a resolution of any

inconsistencies in the evidence as a whole; and Set forth a logical explanation of the

effects of the symptoms . . . on the individual’s ability to work.” Id.

Social Security Ruling 85-15 (“SSR 85-15”) provides guidance for evaluating

the impact of nonexertional impairments, including mental impairments, on a

claimant’s ability to perform work. SSR 85-15 at *1, 1985 WL 56857 (January 1,

1985). “The decisionmaker must not assume that failure to meet or equal a listed

mental impairment equates with capacity to do at least unskilled work. This decision

requires careful consideration of the assessment of” the residual functional capacity.

Id. at *4. “The basic mental demands of competitive, remunerative, unskilled work

include the abilities (on a sustained basis) to understand, carry out, and remember

simple instructions; to respond appropriately to supervision, coworkers, and usual

work situations; and to deal with changes in a routine work setting.” Id.

Ms. Jones argues that after rejecting the medical opinion from N.P. Joiner, the

ALJ “fail[ed] to credit any other medical evidence concerning Ms. Jones’ physical

functioning” and “it is unclear what evidence supports the light [residual functional

capacity] determination.” Doc. 11 at 8. Further, Ms. Jones argues that “[t]he ALJ

failed to cite to any specific medical facts or even persuasive non-medical evidence

in the record that supports his physical [residual functional capacity] determination.”

Id. Finally, Ms. Jones argues that “[t]he ALJ also failed to properly determine Ms.

Jones’ mental [residual functional capacity].” Id. at 9.

The Commissioner argues that “a plain reading of the ALJ’s decision shows

a thorough consideration of the longitudinal record and conclusions consistent with

the ALJ’s role.” Doc. 15 at 12. With respect to mental functions, the Commissioner

argues that Ms. Jones “misread[s] . . . the record.” Id. at 13. And the Commissioner

argues that “[t]he ALJ . . . accounted for the moderate limitations in the [residual

functional capacity] finding.” Id.

In making his residual functional capacity determination, the ALJ “considered

all symptoms and the extent to which these symptoms can reasonably be accepted

as consistent with the objective medical evidence and other evidence” and “the

medical opinions and prior administrative medical findings.” R. 27. The ALJ

discussed Ms. Jones’s benefits application, Functions Reports, and hearing

testimony. R. 28. Then, the ALJ detailed the “objective medical evidence,” the

“longitudinal medical evidence,” physical consultative examination findings,

primary care records, emergency care records, orthopedic care records, pain

management care records, and ophthalmic care records. R. 28–33. The ALJ stated:

Overall, the objective medical evidence does not fully

support the claimant’s allegations of disabling symptoms

since the alleged onset date. While she alleges neck and

back pain limiting her functional ability, imaging studies

show no more than mild degenerative changes.

Additionally, her examination findings since the alleged

onset date through April 2023, show no more than one-

time abnormal findings of paraspinal muscle tenderness,

otherwise, she had normal physical findings. It is not until

April 2023, that she had increased symptoms after being

involved in a motor vehicle accident, but her work up was

unremarkable, including imaging studies of the cervical,

thoracic, and lumbar spine. Moreover, she reported

significant improvement during her orthopedic visits after

completing physical therapy, with examination findings

consistent with her reported improvement. The orthopedic

findings and reported improvement is inconsistent with

primary care visits findings during the same month that

show abnormal physical findings. However, I have also

considered pain management records that show abnormal

physical findings regarding tenderness and decreased

range of motion, but otherwise, she had normal strength,

gait, sensation, and reflexes. Progress notes also show that

she reported some improvement with treatment. Even

though the claimant alleges blindness or low vision, her

workup was unremarkable and there is no objective

evidence to explain her reported blindness. Additionally,

no medical professional or their staff noted that the

claimant had difficulty navigating through their facilities

due to low vision.

The claimant also alleges disabling mental impairment

symptoms. Indeed, the record shows that she was admitted

for inpatient psychiatric care in two occasions, one before

the alleged onset date and the second one nearly two years

later. However, the first one occurred in a setting of non-

compliance with medication for over 10 years and using

amphetamines. I also note that there is no evidence of

outpatient follow up care since October 2022, even though

she alleges disabling symptoms. In any case, her mental

status examination[s] were normal even though she was

depressed and had anxious affect. Additionally, she stated

that she is able to attend classes for medical coding and

billing, despite her reported problems with concentration

and attention. Primary care examinations show that she

had normal attention, concentration, memory, mood, and

affect.

R. 32–33 (citations omitted). And the ALJ found that Ms. Jones’s “activities of daily

living further diminish the persuasiveness of her allegations” and “are consistent

with the ability to perform a range of light work.” R. 33. The ALJ concluded:

Consistent with the evidence discussed above and

considering the effects of her medically determinable

impairments along with her obesity on exertional

functions, and demonstrated normal strength, I find that

she can perform work at a light exertion. I have also taken

into account the effects of her obesity on postural and non-

exertional functions, along with possible symptom

exacerbating factors, and safety precautions for possible

delayed reaction times due to medication side effects and

pain in finding[] that she can never climb ladders, ropes,

or scaffolds; she can frequently stoop, and occasionally

kneel, crouch, or crawl; she can occasionally be exposed

to extreme cold, extreme heat, excessive irritants such as

fumes, odors, dust, and gases, poorly ventilated areas,

chemicals as defined in the Selected Characteristics of

Occupations of the DOT; she can never be exposed to

workplace hazards such as moving mechanical parts and

high, exposed places. Because of her loss of visual acuity

of unknown etiology, I find that she can avoid ordinary

hazards in the workplace (e.g., boxes on floor, doors ajar,

etc.). In considering the claimant’s reported mental

impairment related symptoms, despite normal mental

status exams, I find that she can understand, remember,

and carry out detailed, but not complex instructions; she

cannot perform work requiring a specific production rate,

such as assembly line work, or work that requires hourly

quotas; she can tolerate occasional interaction with the

public, and occasional interaction with coworkers and

supervisor; she can deal with occasional changes in the

work setting.

R. 33–34.

Regarding Ms. Jones’s mental residual functional capacity, the ALJ discussed

the state agency psychological consultation at the initial level and upon

reconsideration, mental health treatment records, and “other evidence such as [Ms.

Jones’s] reported daily activities that demonstrate a greater functional ability.” R.

36–39. With respect to the “non-examining state agency psychologists” cited by Ms.

Jones, see Doc. 11 at 9, the ALJ specifically stated that Dr. Sadovnik “opined that

the claimant can understand and remember simple instructions, locations, and work-

like procedures; she can understand and remember detailed instructions; [and] she

can carry out short and simple and detailed instructions.” R. 36. The ALJ concluded:

However, I have considered the effect the claimant’s

impairments on her ability to perform the mental

requirements of work as set out in SSR 85-15. This ruling

notes that an individual should be able to understand, carry

out and remember simple instructions; respond

appropriately to supervision, coworkers and usual work

situations; and to deal with changes in a routine work

setting. Thus, these are the activities I considered in

reaching the claimant’s residual functional capacity when

finding a moderate limitation in all four broad areas of

mental functioning accommodated by the following: she

can understand, remember, and carry out detailed, but not

complex instructions; she cannot perform work requiring

a specific production rate, such as assembly line work, or

work that requires hourly quotas; she can tolerate

occasional interaction with the public, and occasional

interaction with coworkers and supervisor; she can deal

with occasional changes in the work setting.

R. 37.

The ALJ properly identified Ms. Jones’s functional limitations and assessed

“her work-related abilities on a function-by-function basis.” SSR 96-8p at *1. In

accordance with the ruling, the ALJ’s residual functional capacity finding

“contain[ed] a thorough discussion and analysis of the objective medical and other

evidence,” “[i]nclude[d] a resolution of any inconsistencies in the evidence as a

whole,” and “[s]et forth a logical explanation of the effects of the symptoms” on Ms.

Jones’s “ability to work.” Id. at *7.

Additionally, Ms. Jones’s argument regarding the mental functions in the

residual functional capacity reflects a misreading of the record. Although Ms. Jones

argues that she was “limited to carry out ‘very short’ and simple instructions,” the

cited record evidence specifically states that she can “carry out . . . detailed

instructions.” Doc. 11 at 9; R. 97; see also R. 37; R. 96 (“Claimant understands and

remembers simple instructions as well as locations and work-like procedures. She

demonstrates the ability to understand and remember detailed instructions.”).

The conditions in the residual functional capacity were well-explained and

well-supported by medical evidence. The court discerns no error in the ALJ’s

residual functional capacity analysis.

C. The ALJ’s Step Five Finding

At the fifth step of the disability determination, the Commissioner must show

“the existence of other jobs in the national economy which, given the claimant’s

impairments, the claimant can perform.” Hale v. Brown, 831 F.2d 1007, 1011 (11th

Cir. 1987). In making this determination, the ALJ may take administrative notice of

job data and may use vocational expert testimony. 20 C.F.R. § 404.15.66(d), (e);

Jones v. Apfel, 190 F.3d 1224, 1229 (11th Cir. 1999) (stating that when the claimant

cannot perform a full range of work or has non-exertional impairments that

significantly limit basic work skills, the primary method for determining whether the

claimant can perform other jobs is through vocational expert testimony).

Ordinarily, vocational expert evidence should be consistent with the DOT.

Social Security Ruling 00-4p, 2000 WL 1898704, at *2 (Dec. 4, 2000) (“SSR 00-

4p”). When a vocational expert’s testimony conflicts with the DOT, there are certain

duties that the ALJ must discharge.

Ms. Jones argues that the ALJ erred when he “fail[ed] to reconcile an apparent

conflict” based on the ALJ’s finding regarding Ms. Jones’s ability to follow certain

instructions. Doc. 11 at 10–13. The Commissioner again argues that Ms. Jones’s

“misread[s] . . . the record” with respect to her ability to carry out instructions and

thus her “argument regarding an ‘apparent conflict’ between the [DOT] and the

vocational expert’s testimony must fail.” Doc. 15 at 12–13.

The court agrees with the Commissioner. Although Ms. Jones argues that

there is an apparent conflict, the cited record evidence specifically states that she can

“carry out . . . detailed instructions.” Doc. 11 at 12; R. 97; see also R. 37. Thus, the

ALJ did not err in his step five analysis.

D. The ALJ’s Hypothetical Questioning of the Vocational Expert

“In order for a vocational expert’s testimony to constitute substantial

evidence, the ALJ must pose a hypothetical question which comprises all of the

claimant’s impairments.” Wilson v. Barnhart, 284 F.3d 1219, 1227 (11th Cir. 2002).

The hypothetical question posed by the ALJ need not include impairments that the

ALJ has properly determined to be unsupported by the evidentiary record. Crawford

v. Comm’r, 363 F.3d 1155, 1161 (11th Cir. 2004).

Ms. Jones argues that the ALJ “fail[ed] to account for a finding that [Ms.

Jones] has moderate restrictions in concentration, persistence, or pace in the

accepted hypothetical to the vocational expert.” Doc. 11 at 13. Instead, Ms. Jones

argues that “the accepted hypothetical to the [vocational expert] only limited [Ms.

Jones] mentally to understand, remember, and carry out detailed but not complex

directions; no work with a specific production rate such as an assembly line or work

that requires hourly quotas; occasional interaction with the public, co-workers, and

supervisors; and dealing with no more than occasional changes in the work setting.”

Id. at 14 (citing R. 80–91). The Commissioner argues that “a plain reading of the

ALJ’s decision supports the hypothetical and the conclusions,” Ms. Jones “has not

meaningfully argued that the [residual functional capacity] is insufficient to account

for her limitations,” and “her reliance on caselaw is misplaced.” Doc. 15 at 15.

Instead, the Commissioner argues that “the ALJ explicated accounted for the

moderate limitation in concentration, persistence, or maintaining pace in the

[residual functional capacity] finding.” Id. at 18.

In his decision, the ALJ first addressed Ms. Jones’s mental impairments in his

listing determination, specifically evaluating Ms. Jones’s ability to: understand,

remember, or apply information; interact with others; concentrate, persist, or

maintain pace; and adapt or manage oneself. R. 23–27. The ALJ defined “moderate

limitation” under the listing as: “Your functioning in this area independently,

appropriately, effectively, and on a sustained basis is fair.” R. 24. After discussing

Ms. Jones’s hearing testimony, the objective medical evidence, and daily activities,

the ALJ found that Ms. Jones has a moderate limitation in all four areas. R. 24–26.

The ALJ also wrote:

The limitations identified in the “paragraph B” criteria are

not a residual functional capacity assessment but are used

to rate the severity of mental impairments at steps 2 and 3

of the sequential evaluation process. The mental residual

functional capacity assessment used at steps 4 and 5 of the

sequential evaluation process requires a more detailed

assessment of the areas of mental functioning. The

following residual functional capacity assessment reflects

the degree of limitation I have found in the “paragraph B”

mental function analysis.

R. 27.

In the next step of his decision, the ALJ made his residual functional capacity

determination. R. 27–39. The ALJ specifically detailed Ms. Jones’s mental

impairments, including inpatient care with no evidence of follow-up outpatient

treatment, R. 31–32, primary care records and examination records, R. 32, and

psychological consultative examination results, R. 32. The court detailed the ALJ’s

residual functional capacity determination supra Section IV.B and did not discern

an error.

The ALJ also discussed the medical opinions of Dr. Sadovnik, Dr. Bare, and

Dr. Bynum, and indicated how persuasive he found these opinions and his reasons

for that determination. R. 36–38. The ALJ again referenced “finding a moderate

limitation in all four broad areas of mental functioning,” and he noted that he

considered Ms. Jones’s “ability to perform the mental requirements of work as set

out in SSR 85-15 . . . in reaching [her] residual functional capacity.” R. 37.

At the hearing, the ALJ questioned the vocational expert:

Q Please assume a hypothetical person the same age,

education, past work experience as the claimant, with the

following limitations. The person is capable of light work

as defined in the regulations. The person cannot climb

ladders, ropes and scaffolds. Person can frequently stoop,

occasionally kneel, crouch and crawl. Person can

occasionally be exposed to extreme cold, extreme heat.

Can occasionally be exposed to excessive irritants such as

fumes, odors, dust, gasses, poorly ventilated areas and

chemicals, as defined in the Selected Characteristics of

Occupations of the DOT. The person cannot be exposed to

workplace hazards such as moving mechanical parts and

high exposed placed. Person’s vision is such that they can

avoid ordinary hazards in the workplace like boxes on the

floor, doors ajar and so forth. The person can understand,

remember and carry out detailed but not complex

instructions, but cannot perform work that requires a

specific production rate such as assembly line work or

work that requires hourly quotas. The person can tolerate

occasional interaction with the public and with coworkers

and supervisors. And the person can deal with occasional

changes in the work setting. With those limitations, past

work would be eliminated. Is that correct?

A Yes, sir.

Q Could you name some jobs in [t]he national

economy a person could perform with those limitations?

A Well, there would be Cleaner-Housekeeping . . .

Garment Sorter[.]

R. 80–81.

The ALJ properly evaluated Ms. Jones’s mental functioning in both his listing

determination and in his residual functional capacity determination. See supra

Section IV.B (rejecting plaintiff’s residual functional capacity argument). The ALJ

thoroughly examined the record and explained his decision making. The

hypothetical question posed to the vocational expert incorporated all the limitations

included in the residual functional capacity. Therefore, substantial evidence supports

the ALJ’s determination that “other work . . . exists in significant numbers in the

national economy.” See R. 41.

E. The ALJ’s Evaluation of Ms. Jones’s Subjective Statements

A claimant’s subjective complaints are insufficient to establish a disability.

See 20 C.F.R. § 404.1529(a); Edwards v. Sullivan, 937 F.2d 580, 584 (11th Cir.

1991). Subjective testimony of pain and other symptoms may establish the presence

of a disabling impairment if it is supported by medical evidence. See Foote v. Chater,

67 F.3d 1553, 1561 (11th Cir. 1995). The Eleventh Circuit applies a two-part pain

standard when a claimant claims disability due to pain or other subjective symptoms.

The claimant must show evidence of an underlying medical condition and either (1)

objective medical evidence that confirms the severity of the alleged symptoms

arising from the condition, or (2) that the objectively determined medical condition

is of such severity that it can reasonably be expected to give rise to the alleged

symptoms. See 20 C.F.R. § 404.1529(a), (b); Social Security Ruling 16-3p, 2017

WL 5180304, at *3–*4 (Oct. 25, 2017) (“SSR 16-3p”); Wilson v. Barnhart, 284 F.3d

1219, 1225 (11th Cir. 2002).

If the first part of the pain standard is satisfied, the ALJ then evaluates the

intensity and persistence of a claimant’s alleged symptoms and their effect on her

ability to work. See 20 C.F.R. § 404.1529(c); Wilson, 284 F.3d at 1225–26. In

evaluating the extent to which a claimant’s symptoms affect her capacity to perform

basic work activities, the ALJ will consider (1) objective medical evidence, (2) the

nature of a claimant’s symptoms, (3) the claimant’s daily activities, (4) precipitating

and aggravating factors, (5) the effectiveness of medication, (6) treatment sought for

relief of symptoms, (7) any measures the claimant takes to relieve symptoms, and

(8) any conflicts between a claimant’s statements and the rest of the evidence. See

20 C.F.R. § 404.1529(c)(3), (4); SSR 16-3p at *4, *7–*8. To discredit a claimant’s

statements, the ALJ must clearly “articulate explicit and adequate reasons.” Dyer v.

Barnhart, 395 F.3d 1206, 1210 (11th Cir. 2005).

An ALJ’s review “must take into account and evaluate the record as a whole.”

McCruter v. Bowen, 791 F.2d 1544, 1548 (11th Cir. 1986). There is no rigid

requirement that the ALJ specifically refer to every piece of evidence in his decision.

Jacobus v. Comm’r of Soc. Sec., 664 F. App’x 774, 776 (11th Cir. 2016). Instead,

the ALJ must consider the medical evidence as a whole and not broadly reject the

evidence in the record. Id.

This determination is a question of fact subject only to limited review in the

courts to ensure the finding is supported by substantial evidence. See Hand v.

Heckler, 761 F.2d 1545, 1548–49 (11th Cir. 1985), vacated for rehearing en banc,

774 F.2d 428 (11th Cir. 1985), reinstated sub nom., Hand v. Bowen, 793 F.2d 275

(11th Cir. 1986). The Eleventh Circuit will not disturb a clearly articulated finding

supported by substantial evidence. See Mitchell v. Comm’r, Soc. Sec. Admin., 771

F.3d 780, 782 (11th Cir. 2014). However, a reversal is warranted if the decision

contains no indication of the proper application of the pain standard. See Ortega v.

Chater, 933 F. Supp. 1071, 1076 (S.D. Fla. 1996) (holding that the ALJ’s failure to

articulate adequate reasons for only partially crediting the plaintiff’s complaints of

pain resulted in reversal). “The question is not . . . whether [the] ALJ could have

reasonably credited [claimant’s] testimony, but whether the ALJ was clearly wrong

to discredit it.” Werner v. Comm’r of Soc. Sec., 421 F. App’x 935, 939 (11th Cir.

2011).

Ms. Jones argues that “[t]he ALJ’s evaluation of [her] subjective statements

is not supported by substantial evidence” because “there are extensive clinical and

objective abnormalities that support a finding of physical and/or mental disability

for [her] based on the available medical opinions.” Doc. 11 at 17. Additionally, Ms.

Jones argues that the ALJ erred when referring to her activities of daily living. Id.

The Commissioner argues that “[t]he ALJ properly considered all relevant evidence,

including the objective medical evidence, the prior administrative medical findings,

and [Ms. Jones’s] admitted daily activities and determined that this evidence was not

entirely consistent with [her] subjective statements about the levels of intensity,

persistence, and limiting effects of her impairments.” Doc. 15 at 19.

It is clear the ALJ applied the Eleventh Circuit’s pain standard. After

explaining the pain standard, with citations to 20 C.F.R. § 404.1529 and SSR 16-3p,

the ALJ considered Ms. Jones’s testimony about her symptoms. See R. 27–28. With

respect to Ms. Jones’s hearing testimony, the ALJ summarized it as follows:

At the hearing, the claimant endorsed ongoing impairment

related symptoms such as, but not limited to low vision,

neck and back pain radiating to extremities, generalized

fibromyalgia body pain, limited ability to stand, walk, or

sit for prolonged periods, shortness of breath exacerbated

by temperature extremes, allergies, and walking, recurrent

migraines with light and noise sensitivity, abdominal pain

with frequent need to use the restroom, difficulty

concentrat[ing], being around[] others, completing tasks,

anxiousness, nervousness, and panic attacks. She

estimated that she can [sit] for no more than 20 minutes,

walk for about 20 to 30 minutes, and lift no more than a

gallon of milk. She also stated that she needs to lie down

throughout the day and elevate legs 3 to 4 times a day for

30 minutes each time. The claimant further stated that she

is currently enrolled and taking classes for medical billing

and coding and is able to read, write, and use a cell phone.

R. 28; see also R. 64.

“After careful consideration of the evidence,” the ALJ found “that the

claimant’s medically determinable impairments could reasonably be expected to

cause the alleged symptoms.” R. 28; see R. 29–33 (chronological discussion of

medical evidence). The ALJ then found that Ms. Jones’s “statements concerning the

intensity, persistence[,] and limiting effects of these symptoms are not entirely

consistent with the medical evidence and other evidence in the record.” R. 28. The

ALJ stated that “[t]he objective medical evidence supports that the claimant has

severe impairments of degenerative disc disease, fibromyalgia, loss of central visual

acuity, depression, bipolar disorder, anxiety disorder, and amphetamine use

disorder.” R. 29. The ALJ also found that “obesity is a severe impairment.” R. 29.

The ALJ continued: “However, the evidence does not fully support that the claimant

is as limited as alleged. Rather, the evidence supports that the claimant retains a

residual functional capacity for a light exertion with the . . . postural and non-

exertional functions” given here. R. 29.

The ALJ limited Ms. Jones to light work “[c]onsistent with the evidence . . .

and considering the effects of her medically determinable impairments along with

her obesity . . . and demonstrated normal strength.” R. 33. In imposing additional

limitations on light work, the ALJ took “into account the effects of her obesity on

postural and non-exertional functions, along with possible symptom exacerbating

factors, and safety precautions.” R. 33. And in imposing certain mental functioning

limitations, the ALJ considered Ms. Jones’s “reported mental impairment related

symptoms, despite normal mental status exams.” R. 34.

The ALJ properly evaluated Ms. Jones’s symptoms consistent with the

Eleventh Circuit’s pain standard and his decision was supported by substantial

evidence. After discussing Ms. Jones’s testimony, R. 28, the ALJ summarized the

medical evidence, R. 29–33. The medical evidence cited by the ALJ – generally

unremarkable findings and routine and conservative treatment – supports the ALJ’s

finding that Ms. Jones’s allegations of disabling limitations were not fully consistent

with the evidence. Additionally, in accordance with the regulations, the ALJ’s

consideration of Ms. Jones’s activities of daily living was appropriate.

The ALJ acknowledged Ms. Jones’s medical history and testimony and

accounted for Ms. Jones’s subjective complaints when he determined Ms. Jones was

limited to light work with additional limitations. Accordingly, there is no error in the

ALJ’s consideration of Ms. Jones’s subjective complaints.

Vv. Conclusion

The ALJ’s determination that Ms. Jones is not disabled is supported by

substantial evidence. The Commissioner’s final decision is therefore affirmed. A

separate order will be entered.

DONE and ORDERED this 20th day of January, 2026.

UNITED STATES DISTRICT JUDGE

35