The opinion
IN THE UNITED STATES DISTRICT COURT
FOR THE SOUTHERN DISTRICT OF OHIO
WESTERN DIVISION
JOEL P.1, Case No. 3:25-cv-153
Plaintiff, Litkovitz, M.J.
vs.
COMMISSIONER OF ORDER
SOCIAL SECURITY,
Defendant.
Plaintiff Joel P. brings this action under 42 U.S.C. § 405(g) for judicial review of the final
decision of the Commissioner of Social Security (Commissioner) denying his application for
disability insurance benefits (DIB). This matter is before the Court on plaintiff’s statement of
errors (Doc. 7), the Commissioner’s response in opposition (Doc. 8), and plaintiff’s reply
memorandum (Doc. 9).
I. Procedural Background
Plaintiff filed an application for DIB on January 19, 2022, alleging an onset of disability
on December 11, 2021, due to depression, back injury, arthritis, nerve damage, stomach damage
due to a lap band, and vision issues due to a concussion. (Tr. 179-83, see also Tr. 268). His
application was denied initially and upon reconsideration. Plaintiff, through counsel, requested
and was granted a de novo telephone hearing before administrative law judge (ALJ) Stuart
Adkins. Plaintiff and a vocational expert (VE) appeared telephonically and testified at the ALJ
hearing on November 27, 2023. (Tr. 33-70). On March 06, 2024, the ALJ issued a decision
denying plaintiff’s application. (Tr. 14-32). On March 14, 2025, the Appeals Council denied
1 Pursuant to General Order 22-01, due to significant privacy concerns in social security cases, any
opinion, order, judgment or other disposition in social security cases in the Southern District of Ohio shall
refer to plaintiffs only by their first names and last initials..
plaintiff’s request for review, making the ALJ’s decision the final decision of the Commissioner.
(Tr. 1-6).
II. Analysis
A. Legal Framework for Disability Determinations
To qualify for disability benefits, a claimant must suffer from a medically determinable
physical or mental impairment that can be expected to result in death or that 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).
The impairment must render the claimant unable to engage in the work previously performed or
in any other substantial gainful employment that exists in the national economy. 42 U.S.C. §§
423(d)(2), 1382c(a)(3)(B).
Regulations promulgated by the Commissioner establish a five-step sequential evaluation
process for disability determinations:
1) If the claimant is doing substantial gainful activity, the claimant is not disabled.
2) If the claimant does not have a severe medically determinable physical or
mental impairment – i.e., an impairment that significantly limits his or her
physical or mental ability to do basic work activities – the claimant is not
disabled.
3) If the claimant has a severe impairment(s) that meets or equals one of the
listings in Appendix 1 to Subpart P of the regulations and meets the duration
requirement, the claimant is disabled.
4) If the claimant’s impairment does not prevent him or her from doing his or her
past relevant work, the claimant is not disabled.
5) If the claimant can make an adjustment to other work, the claimant is not
disabled. If the claimant cannot make an adjustment to other work, the claimant
is disabled.
Rabbers v. Comm’r of Soc. Sec., 582 F.3d 647, 652 (6th Cir. 2009) (citing 20 C.F.R. §§
404.1520(a)(4)(i)-(v), 404.1520(b)-(g)). The claimant has the burden of proof at the first four
steps of the sequential evaluation process. Id.; Wilson v. Comm’r of Soc. Sec., 378 F.3d 541, 548
(6th Cir. 2004). Once the claimant establishes a prima facie case by showing an inability to
perform the relevant previous employment, the burden shifts to the Commissioner to show that
the claimant can perform other substantial gainful employment and that such employment exists
in the national economy. Rabbers, 582 F.3d at 652; Harmon v. Apfel, 168 F.3d 289, 291 (6th
Cir. 1999).
B. The Administrative Law Judge’s Findings
The ALJ applied the sequential evaluation process and made the following findings of
fact and conclusions of law:
1. [Plaintiff] meets the insured status requirements of the Social Security Act
through September 30, 2027.
2. [Plaintiff] has not engaged in substantial gainful activity since December 11,
2021, the alleged onset date (20 CFR 404.1571 et seq.).
3. [Plaintiff] has the following severe impairments: degenerative disc disease,
lumbar and cervical spine; hernia; shoulder osteoarthritis; coronary artery disease;
and ventricular tachycardia (20 CFR 404.1520(c)).
4. [Plaintiff] 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 and 404.1526).
5. After careful consideration of the entire record, the [ALJ] finds that [plaintiff]
has the residual functional capacity to perform light work as defined in 20 CFR
404.1567(b) except: can lift and/or carry 20 pounds occasionally and 10 pounds
frequently; can stand and/or walk for about 4 hours and sit for about 6 hours in an
8 hour workday; can never climb ladders[,] ropes[,] and scaffolds; can occasionally
climb ramps and stairs, stoop, kneel, crouch and crawl; can frequently balance; can
occasionally reach overhead, bilaterally; can tolerate occasional concentrated
exposure to extreme cold and vibration; should avoid unprotected heights,
dangerous machinery and commercial driving; and would require use of cane for
ambulation.
6. [Plaintiff] is unable to perform any past relevant work (20 CFR 404.1565).2
2 Plaintiff’s past relevant work was as a track moving, surfacing, and repair operator, very heavy, semi-
7. [Plaintiff] was born [in]… 1972 and was 49 years old, which is defined as a
younger individual age 18-49, on the alleged disability onset date. [Plaintiff]
subsequently changed age category to closely approaching advanced age (20 CFR
404.1563).
8. [Plaintiff] has at least a high school education (20 CFR 404.1564).
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
[plaintiff] is “not disabled,” whether or not [plaintiff] has transferable job skills
(See SSR 82-41 and 20 CFR Part 404, Subpart P, Appendix 2).
10. Considering [plaintiff]’s age, education, work experience, and residual
functional capacity, there are jobs that exist in significant numbers in the national
economy that [plaintiff] can perform (20 CFR 404.1569 and 404.1569a).3
11. [Plaintiff] has not been under a disability, as defined in the Social Security Act,
from December 11, 2021, through the date of this decision (20 CFR 404.1520(g)).
(Tr. 19-27).
C. Judicial Standard of Review
Judicial review of the Commissioner’s determination is limited in scope by 42 U.S.C. §
405(g) and involves a twofold inquiry: (1) whether the findings of the ALJ are supported by
substantial evidence, and (2) whether the ALJ applied the correct legal standards. See Blakley v.
Comm’r of Soc. Sec., 581 F.3d 399, 405 (6th Cir. 2009); see also Bowen v. Comm’r of Soc. Sec.,
478 F.3d 742, 745-46 (6th Cir. 2007).
skilled position, performed at the very heavy level; cable television installer, heavy, semi-skilled position,
performed at the heavy level; security guard, light, semi-skilled position, performed at the medium level;
grain receiver, light, unskilled position, performed at the medium level; department manager, medium,
skilled position; overhead crane operator, medium, semi-skilled position, performed at the heavy level;
welder, production line, medium, unskilled, position; and compressed gas plant worker, medium, unskilled
position. (Tr. 25-26, 63).
3 The ALJ relied on the VE’s testimony to find that plaintiff would be able to perform the requirements of
representative unskilled, light occupations in the national economy such as warehouse checker (100,000
jobs in the national economy); marker (50,000 jobs in the national economy); and office mail clerk
(100,000 jobs in the national economy). (Tr. 26-27, 65).
The Commissioner’s findings must stand if they are supported by “such relevant evidence
as a reasonable mind might accept as adequate to support a conclusion.” Biestek v. Berryhill,
587 U.S. 97, 103 (2019) (quoting Consolidated Edison Co. v. N.L.R.B., 305 U.S. 197, 229
(1938)). Substantial evidence consists of “more than a scintilla of evidence but less than a
preponderance. . . .” Rogers v. Comm’r of Soc. Sec., 486 F.3d 234, 241 (6th Cir. 2007). In
deciding whether the Commissioner’s findings are supported by substantial evidence, the Court
considers the record as a whole. Hephner v. Mathews, 574 F.2d 359 (6th Cir. 1978).
The Court must also determine whether the ALJ applied the correct legal standards in the
disability determination. Even if substantial evidence supports the ALJ’s conclusion that the
plaintiff is not disabled, “a decision of the Commissioner will not be upheld where the SSA fails
to follow its own regulations and where that error prejudices a claimant on the merits or deprives
the claimant of a substantial right.” Rabbers, 582 F.3d at 651 (quoting Bowen, 478 F.3d at 746).
See also Napier v. Comm’r of Soc. Sec., 127 F.4th 1000, 1004 (6th Cir. 2025) (“Even when an
ALJ’s decision is supported by substantial evidence, we will reverse the decision if we find that
the ALJ failed to follow the applicable procedural regulations.”) (citing Miller v. Comm’r of Soc.
Sec., 811 F.3d 825, 833 (6th Cir. 2016)).
D. Specific Errors
On appeal, plaintiff contends that: (1) the ALJ failed “to meet the articulation demands
of regulations when appraising the persuasiveness of the medical opinion evidence of record”;
(2) the ALJ “mischaracterizes the opinions of consulting examiner Dr. Tanley”; and (3) the ALJ
failed “to adequately consider and account for Plaintiff’s mental health impairments throughout
his disability evaluation.” (Doc. 7 at PageID 1300-09). The Commissioner responds that the
ALJ’s decision, when read as a whole, adequately demonstrates substantive consideration of the
supportability and consistency factors; the ALJ was not required to consider factors other than
supportability and consistency; the ALJ’s evaluation of Dr. Tanley’s opinion is supported by
substantial evidence; and the ALJ’s reasoning for including no mental limitations in the RFC
finding are “easily traceable.” (Doc. 8 at PageID 1314-28).
1. The ALJ’s Evaluation of the Medial Opinion Evidence
ALJs must adhere to agency regulations governing the evaluation of medical opinion
evidence. Under the regulations applicable to plaintiff’s claims, the Commissioner will “not
defer or give any specific evidentiary weight, including controlling weight, to any medical
opinion(s) or prior administrative medical finding(s)4, including those from your medical
sources.” 20 C.F.R. § 404.1520c(a). Rather, the Commissioner will consider “how persuasive”
the medical opinion is. 20 C.F.R. § 404.1520c(b).
In determining the persuasiveness of a medical opinion, the ALJ considers five factors:
(1) supportability, (2) consistency, (3) relationship with the claimant, including length of
treatment relationship, frequency of examinations, purpose of the treatment relationship, and
examining relationship, (4) specialization, and (5) other factors that tend to support or contradict
a medical opinion. 20 C.F.R. § 404.1520c(c)(1)-(5). The most important factors the ALJ must
consider are supportability and consistency. 20 C.F.R. § 404.1520c(b)(2). With respect to the
supportability factor, “[t]he more relevant the objective medical evidence5 and supporting
explanations presented by a medical source are to support his or his medical opinion(s) . . . the
4 A “prior administrative medical finding” is defined as “[a] finding, other than the ultimate determination
about whether the individual is disabled, about a medical issue made by an MC [medical consultant] or PC
[psychological consultant] at a prior administrative level in the current claim.” 82 Fed. Reg. 5844-01, 2017 WL
168819, at *5850. For clarity, the Court will refer to the limitations opined by the state agency reviewing physicians
and psychologists as “assessments” or “opinions.”
5 Objective medical evidence is defined as “signs, laboratory findings, or both.” 82 Fed. Reg. 5844-01, 2017 WL
168819, at *5850.
more persuasive the medical opinions . . . will be.” 20 C.F.R. § 404.1520c(c)(1). Similarly,
“[t]he more consistent a medical opinion(s) . . . is with the evidence from other medical sources
and nonmedical sources in the claim, the more persuasive the medical opinion(s). . . .” 20 C.F.R.
§ 404.1520c(c)(2). The ALJ is required to “explain how [he/she] considered the supportability
and consistency factors for a medical source’s medical opinions” in the written decision. 20
C.F.R. § 404.1520c(b)(2). Conversely, the ALJ “may, but [is] not required to, explain” how
he/she considered the relationship, specialization, and other factors set forth in paragraphs (c)(3)
through (c)(5) of the regulation. Id. However, where two or more medical opinions or prior
administrative findings about the same issue are equally persuasive, the ALJ must articulate how
he or she “considered the other most persuasive factors in paragraphs (c)(3) through (c)(5). . . .”
20 C.F.R. § 404.1520c(b)(3). Finally, the ALJ is not required to articulate how he or she
considered evidence from nonmedical sources. 20 C.F.R. § 404.1520c(d).
a. Consultative examiner, James Tanley, Ph.D.
In September 2022, James Tanley, Ph.D., consultatively examined plaintiff and noted his
mental status examination was unremarkable. (Tr. 583-84). He found no specific limitations in
understanding, remembering, and carrying out instructions; maintaining attention, concentration,
persistence, pace, and performing tasks; responding appropriately to supervision and coworkers
in a work setting; and responding appropriately to work pressures. (Tr. 584-85). Dr. Tanley
diagnosed plaintiff with an unspecified mood disorder. (Tr. 584). Narratively, Dr. Tanley noted
that “[w]ere [plaintiff’s] mood problems to worsen, they could negatively impact [the] domain of
[attention and concentration] by interfering with his ability to focus and to concentrate.” (Tr.
585). He also noted plaintiff’s “unremarkable social presentation,” self-reports of doing “okay
with people,” and lack of reported difficulties socially in prior work settings, but Dr. Tanley
remarked that “mood problems could make the free and easy commerce of social interaction on
the job a bit problematic.” (Id.). Finally, Dr. Tanley observed that plaintiff has “no reported
history of mental or emotional deterioration in response to work exposure,” but his “mood
problems could potentially lower his frustration tolerance a bit and put him slightly at risk for the
pressures of work.” (Id.).
The ALJ found Dr. Tanley’s opinion “generally persuasive.” (Tr. 25). The ALJ
evaluated Dr. Tanley’s opinion as follows:
Dr. Tanley examined the claimant and gave conclusions generally consistent with
a finding of non-severe mental health impairments and no more than mild
limitations in any mental health area. Such a conclusion is consistent with the
overall evidence. Additionally, Dr. Tanley’s conclusions are generally consistent
with the other opinion evidence of record (B2A; B4A).
(Tr. 25) (citing generally to the Disability Determination Explanations at the initial and
reconsideration level, Tr. 90-98 and 100-108, respectively). The issue, then, is whether this
extremely sparse discussion meets the articulation requirement, i.e., makes “the reasons for the
supportability and consistency analysis sufficiently clear for subsequent review to determine
whether substantial evidence supports the claimant’s disability determination.” Ryan A. v.
Comm’r of Soc. Sec., No. 1:24-cv-475, 2025 WL 1752000, at *5 (S.D. Ohio June 25, 2025)
(quoting Hritz v. Comm’r of Soc. Sec., No. 1:23-cv-235, 2024 WL 83032, at *9 (N.D. Ohio Jan.
8, 2024)).
As noted above, the supportability analysis requires examination of the objective
medical evidence and supporting explanations presented by the medical source to support his
medical opinion. 20 C.F.R. § 404.1520c(c)(1). Similarly, “[t]he more consistent a medical
opinion(s) . . . is with the evidence from other medical sources and nonmedical sources in the
claim, the more persuasive the medical opinion(s). . . .” 20 C.F.R. § 404.1520c(c)(2).
In determining whether the ALJ adequately explained how he evaluated consistency and
supportability, “[c]ourts are permitted to look elsewhere in the ALJ’s decision as the ALJ does
not need to ‘spell out every fact a second time.’” Brenda W. v. Comm’r of Soc. Sec., No. 2:24-
cv-1128, 2025 WL 2750479, at *3 (S.D. Ohio Sept. 29, 2025) (citing Forrest v. Comm’r of Soc.
Sec., 591 F. App’x 359, 366 (6th Cir. 2014)). See also Booker R. v. Comm’r of Soc. Sec., No.
3:22-cv-170, 2023 WL 4247312, at *4-5 (S.D. Ohio June 29, 2023) (“[M]eaningful judicial
review exists—even if the ALJ provided only a cursory or sparse analysis—if the ALJ made
sufficient factual findings elsewhere in the decision that support her conclusion.”); Lillian A. v.
O’Malley, No. 4:23-cv-4, 2024 WL 987571, at *2 (W.D. Ky. Mar. 7, 2024) (“[I]t is sufficient
for an ALJ’s reasons for determining the consistency of a medical opinion to be found
elsewhere in the decision[.]”).
Viewing the ALJ’s opinion as a whole, the evaluation of Dr. Tanley’s opinion is
supported by substantial evidence. As to supportability, the ALJ discussed Dr. Tanley’s
findings more extensively in finding plaintiff’s mood disorder nonsevere at step two of the
sequential evaluation process. (Tr. 20-21). Specifically, the ALJ cited Dr. Tanley’s statements
that plaintiff: has never been psychiatrically hospitalized and did not regularly receive mental
health treatment during the relevant period (Tr. 20, citing Tr. 582); takes Fluoxetine as
prescribed by his primary care provider (Id.); was fully oriented with normal memory (Tr. 20,
citing Tr. 583); had “no difficulty” understanding, remembering, and following instructions (Tr.
20, citing Tr. 585);6 was “unimpaired” in maintaining attention, concentration, persistence and
pace in both simple and multistep tasks (Tr. 20, citing Tr. 585); and had “unremarkable social
presentation” with no history of deterioration in work settings (Id.).
6 The ALJ cited to Tr. 585, but Dr. Tanley’s note on this issue begins at Tr. 584.
As to consistency with other medical and nonmedical evidence, the ALJ noted that
“other opinion evidence indicates no more than mild limitation.” (Tr. 20, citing Tr. 90-98 and
100-108). In addition, plaintiff “routinely denied altered mental status, depression,
hallucinations, memory loss, and suicidal ideas.” (Tr. 20, citing Tr. 366, 467, 521, 537, 548,
555, 1103, 1108, 1113, 1130, 1145, 1158, 1172, and 1179). As the ALJ’s opinion, taken as a
whole, adequately explains how he considered the supportability and consistency factors in
evaluating the persuasiveness of Dr. Tanley’s opinion, plaintiff’s assignment of error will be
overruled as to Dr. Tanley.
b. State agency reviewing consultants, Mary Hill, Ph.D., and Janet
Souder, Psy.D.
Mary Hill, Ph.D., reviewed plaintiff’s file initially in September 2022 and assessed that
plaintiff’s mental impairments are nonsevere and cause no more than mild limitation in any
mental health area. (Tr. 93). Dr. Hill noted that plaintiff’s file contains no evidence of memory
impairment despite his allegation. There were no diagnoses, complaints, or referrals for
cognitive evaluation; and a consultative psychological examination from Dr. Tanley showed no
significant symptoms due to psychological impairments. (Id.). Upon reconsideration, Janet
Souder, Psy.D., reviewed plaintiff’s file in April 2023, and adopted Dr. Hill’s assessment. (Tr.
103).
The ALJ found the prior administrative medical findings of Drs. Hill and Souder to be
“persuasive.” (Tr. 24). The ALJ concluded that their opinions “are consistent with the overall
evidence, including [plaintiff]’s nature and frequency of treatment, as well as examination
findings of record. Moreover, their opinion is generally consistent with the other opinion
evidence.” (Tr. 24, citing Dr. Tanley’s Report, Tr. 580-86).
Although quite succinct, the ALJ’s opinion, taken as a whole, adequately explains how he
considered the supportability and consistency factors in evaluating the persuasiveness of the state
agency reviewing consultants’ opinion. As to supportability, the ALJ reviewed and considered
the dearth of mental health treatment in the record and plaintiff’s unremarkable evaluation by Dr.
Tanley, which Drs. Hill and Souder addressed in their assessments. (Tr. 24, 20, 94-5, 104-5).
As for consistency, the ALJ again concluded that Dr. Tanley, Dr. Hill, and Dr. Souder all
found plaintiff’s mood disorder non-severe and causing “no more than mild limitation in any
mental health area.” (Tr. 24). In addition, he noted plaintiff’s consistent denials of altered
mental status, depression, hallucinations, memory loss, and suicidal ideation. (Tr. 24 and Tr. 20,
citing Tr. 366, 467, 521, 537, 548, 555, 1103, 1108, 1113, 1130, 1145, 1158, 1172, and 1179).
Plaintiff contends that Dr. Tanley’s report “appears to endorse the presence of psychiatric
vocational restrictions” that “contradict Drs. Hill and Souder’s non-severity premise.” (Doc. 7 at
PageID 1303, citing Tr. 585). The single page of Dr. Tanley’s report on which plaintiff relies
provides:
Describe the claimant’s abilities and limitations in maintaining attention and
concentration, and in maintaining persistence and pace to perform simple
tasks and to perform multistep tasks.
This was unimpaired during the interview portion of the exam. He responded
appropriately and in timely fashion to all examiner questions. Given that his verbal
intellectual functioning is estimated to be no higher than Average, he would be
expected to show little or no difficulty with tasks of increasing complexity and
multistep tasks. Were his mood problems to worsen, they could negatively impact
this domain by interfering with his ability to focus and to concentrate.
Describe the claimant’s abilities and limitations in responding appropriately
to supervision and to coworkers in a work setting.
The claimant made an unremarkable social presentation in this setting today. “I do
okay with people.” He did not report problems with people while on the job.
However, his current mood problems could make the free and easy commerce of
social interaction on the job a bit problematic.
Describe the claimant’s abilities and limitations in responding appropriately
to work pressures in a work setting.
There is no reported history of mental or emotional deterioration in response to
work exposure. His current mood problems could potentially lower his frustration
tolerance a bit and put him slightly at risk for the pressure of work.
(Tr. 585). The Court sees nothing here that would contradict the finding that plaintiff’s mental
health impairments are nonsevere. In addition, the ALJ credited Dr. Tanley’s examination
results but was unconvinced by the examiner’s speculation that plaintiff “could” potentially be at
“slight” risk for difficulties with work pressure. (Tr. 20, citing Tr. 585).
Plaintiff next contends that, since the ALJ found the opinions of Drs. Hill, Souder, and
Tanley consistent with one another, the differences in their opinions triggered heightened
articulation requirements under the regulations. (Doc. 7 at PageID 1303-04). The Court
disagrees.
The regulation at issue provides:
Equally persuasive medical opinions or prior administrative medical findings about
the same issue. When we find that two or more medical opinions or prior
administrative medical findings about the same issue are both equally well-
supported . . . and consistent with the record . . . but are not exactly the same, we
will articulate how we considered the other most persuasive factors in paragraphs
(c)(3) through (c)(5) of this section . . . .
20 C.F.R. § 404.1520c(b)(3).
Here, the opinions of Drs. Hill and Souder address the same issues and reach identical
conclusions. (Compare Tr. 93 with Tr. 103). Drs. Hill and Souder expressed the following
opinions:
Mental Limitation Selection
Understand, remember, or apply information None
Interact with others None
Concentrate, persist, or maintain pace Mild
Adapt or manage oneself Mild
(Tr. 93, Tr. 103).
Dr. Tanley, however, did not express a limitation opinion of none, mild, moderate, marked, or
extreme in evaluating the four broad functional areas for mental disorders in the Listing of
Impairments (20 C.F.R., Part 404, Subpart P, Appendix 1) commonly known as “paragraph B”
criteria. If he had done so, and if he had expressed an opinion different from those of Drs. Hill
and Souder (e.g., finding a moderate limitation in ability to adapt or manage oneself), then the
heightened articulation requirement would have been triggered pursuant to 20 C.F.R. §
404.1520c(b)(3).
Instead, Dr. Tanley completed a functional assessment and described plaintiff’s abilities
and limitations in his own terms. (Tr. 581-585). The ALJ found Dr. Tanley’s opinion to be
consistent with those of Drs. Hill and Souder, and, as the Court found above, the ALJ’s opinion
is supported by substantial evidence. (Tr. 24-25). Plaintiff claims, without citation to any
authority, that “[t]he opinion of Dr. Tanley cannot sustainably stand as the sole cited source of
support for the opinions of Drs. Hill and Souder while also not even speaking to the ‘same
issues’ addressed in those opinions.” (Doc. 9 at PageID 1332). Plaintiff’s assertion confuses
two separate issues: (1) the records appropriate for consideration in assessing consistency; and
(2) the level of similarity required to trigger the heightened articulation requirement in 20 C.F.R.
§ 404.1520c(b)(3).
First, the ALJ relied on Dr. Tanley’s functional assessment in assessing the consistency
of Drs. Hill and Souder because plaintiff cited no other mental health opinions in the record. As
the ALJ accurately noted, plaintiff has not regularly received mental health treatment, has never
been psychiatrically hospitalized, takes a single mental health medication prescribed by his
primary care physician, and routinely denied altered mental status, depression, hallucinations,
memory loss, and suicidal ideation. (Tr. 20). Thus, the ALJ appropriately compared the
opinions of Drs. Hill, Souder, and Tanley in evaluating the consistency of their opinions “with
the evidence from other medical sources and nonmedical sources in the claim” pursuant to 20
C.F.R. § 404.1520c(c)(2). Plaintiff has cited no authority requiring that the “evidence from other
medical sources and nonmedical sources” evaluate the same issue to find them persuasive for
purposes of the consistency evaluation required by § 404.1520c(c)(2). Indeed, it would be
counterintuitive to require medical and nonmedical sources to evaluate the same issues.
Second, to trigger the heightened articulation requirement in § 404.1520c(b)(3), entitled
“Equally persuasive medical opinions or prior administrative medical findings about the same
issue,” the opinions must, as explicitly required by the language of the regulation, be “about the
same issue.” 20 C.F.R. § 404.1520c(b)(3). Therefore, because Dr. Tanley did not address the
same issues as Drs. Hill and Souder, and because Drs. Hill and Souder reached identical
conclusions on identical issues, the heightened articulation requirement was not triggered, and
plaintiff’s statement of error as to the ALJ’s evaluation of the opinions of Drs. Hill and Souder
will be overruled.
c. Consultative examiner Babatunde Onamusi, M.D.
Dr. Babatunde Onamusi, M.D., examined plaintiff for disability purposes on May 25,
2022. (Tr. 391-98). Plaintiff complained of pain in his back, knees, and ankles, which started 15
years prior to the examination. He denied any preceding injuries. He reportedly had a
discectomy in 2012 and last saw the surgeon that same year. His most recent MRI of the lumbar
spine was in 2020, and he was told that he had arthritis and no specific treatment intervention
was recommended. At his examination by Dr. Onamusi, plaintiff reported constant severe pain
in his back which was aggravated by standing, walking, bending or lifting. He further reported
radiating pain with numbness and tingling down both legs, describing a burning sensation in both
legs that felt like they were on fire. Although he had not sought treatment, plaintiff described
constant severe to very severe pain in his knees and ankles, aggravated by standing or walking,
as well as weakness in his arms. (Tr. 396).
Examination revealed “normal appearance, not ill-looking and not in distress,” with
normal muscle strength and tone in all muscle groups. (Tr. 397). Plaintiff’s reflexes in his
ankles, knees, elbows, and wrists were 2+ and symmetrical with no pedal edema, and normal
peripheral pulses. (Id.). Dr. Onamusi noted that plaintiff walked with a somewhat broad-based
gait with short strides and had apparent difficulty walking on his heels and toes. (Tr. 397-98).
Dr. Onamusi observed that plaintiff exhibited “a fair amount of pain behavior during the physical
exam with grimacing, moaning, and disproportionate pain response during palpatory
examination.” (Tr. 398). Plaintiff’s back examination revealed symmetrical spine with limited
flexion as plaintiff “exhibited so much pain” that Dr. Onamusi discontinued range of motion
testing of the spine. (Id.). Examination further revealed normal appearance and full range of
motion in all extremity joints with no crepitus or demonstrable instability in his knees. (Id.).
Plaintiff could grip and grasp with both hands, although grip strength in his right hand
(90 pounds) was stronger than with his left (21 pounds). Plaintiff was able to reach forward and
push and pull with both hands as well as use his hands for fine coordination and manipulative
tasks. (Tr. 398).
Dr. Onamusi assessed chronic back and polyarticular pain of the extremities status post
lumbar discectomy in 2012. (Id.). He concluded that plaintiff “is able to sit frequently, stand or
walk low end of frequently, bend occasionally, squat with support occasionally, climb steps
occasionally, lift up to 40 pounds occasionally, [and] use the upper extremities for gross and fine
motor tasks frequently.” (Tr. 398).
The ALJ found Dr. Onamusi’s opinion “somewhat persuasive.” (Tr. 24-25). The ALJ
determined that Dr. Onamusi “generally concluded that plaintiff can perform activities consistent
with a range of light work.” (Tr. 24). However, the ALJ described his findings as “somewhat
vague with respect to standing and walking.” (Id.). The ALJ “curbed” the evidence “in a light
more favorable” to plaintiff by limiting his RFC to standing and walking for only four hours per
day and allowing for the use of a cane. (Tr. 25). The ALJ found Dr. Onamusi’s opinion
regarding frequent use of the upper extremities in all directions to be “unsupported by his own
examination findings” and limited the RFC to only occasionally reaching overhead bilaterally.
(Tr. 25, 22).
Plaintiff contends that the ALJ erred by failing to address the consistency of Dr.
Onamusi’s opinions with other medical evidence, as required by 20 C.F.R. § 404.1520c(b)(2).
(Doc. 7 at PageID 1306). The consistency analysis “involves comparing a medical opinion or
prior administrative medical finding with the evidence from other medical sources and
nonmedical sources in the claim.” Teresa A. v. Comm’r of Soc. Sec., No. 2:23-cv-036, 2024 WL
62646, at *4 (S.D. Ohio Jan. 5, 2024), report and recommendation adopted, 2024 WL 4403751
(S.D. Ohio Oct. 4, 2024) (quoting Cindy F. v. Comm’r of Soc. Sec. Admin., No. 3:21-cv-00047,
2022 WL 4355000, at *7 n.5 (S.D. Ohio Sept. 20, 2022) (quoting 20 C.F.R. § 404.1520c(c)(2)
(emphasis added)). The ALJ’s sole statement specifically evaluating the consistency of Dr.
Onamusi’s medical opinion occurs in the paragraph immediately preceding his evaluation of Dr.
Onamui’s opinion. In evaluating the consistency of the opinions of Drs. Green and Hughes, the
ALJ stated, “Their findings are generally consistent with the overall evidence, including other
opinion evidence.” (Tr. 24, citing to Dr. Onamusi’s consultative examination report (Tr. 390-
98)).
The Court agrees with plaintiff that this single-sentence consistency finding does little to
explain the consistency of Dr. Onamusi’s opinion with the other medical and nonmedical
evidence. However, an examination of the ALJ’s entire opinion regarding plaintiff’s back and
shoulder problems provides additional elucidation. The ALJ accurately discussed medical
records from plaintiff’s examination shortly before the ALJ hearing at Reid Health
Comprehensive Bone and Joint Center. (Tr. 23, citing Tr. 1158-60). Specifically, plaintiff’s
March 2023 spinal x-ray and MRI showed evidence of a previous hemilaminectomy at L4-L5
and L5-S1 and mild-to-moderate spondylosis with bilateral hip degenerative changes. (Tr. 23,
citing Tr. 1159-60). An April 2023 x-ray showed degenerative changes at C5-C6 and C4-C5
with disc height loss and collapse sclerosis osteophytes. (Tr. 23, citing Tr. 1159). Plaintiff’s
medical provider found that the imaging showed a history of decompression with “no significant
residual stenosis” and that a diagnostic EMG was negative for radiculopathy resulting in a
conservative treatment recommendation, including epidural injections and medication
management. (Tr. 23, quoting Tr. 1160). The ALJ further indicated that plaintiff’s October 3,
2023 examination revealed a normal range of motion, normal straight leg raise, and full 5/5
motor strength in plaintiff’s lower extremities. (Tr. 23, citing Tr. 1159). At that time, plaintiff
demonstrated ataxic short gait without assistance but inability to heel or toe walk or tandem gait
without assistance. (Tr. 23, citing Tr. 1158). The ALJ further noted that plaintiff’s previous
MRI showed mild degenerative AC joint changes and mild tenosynovitis and supraspinatus
tendinopathy but no evidence of a rotator cuff tear. (Tr. 23, citing Tr. 578).
As the ALJ discussed, Dr. Onamusi’s examination similarly demonstrated 5/5 muscle
strength and normal range of motion in his bilateral shoulders and arms (Tr. 23, citing Tr. 391-
94) and the ability to reach, push and pull as well as use his hands for fine coordination and
manipulative tasks (Tr. 24, citing Tr. 398). The ALJ noted Dr. Onamusi’s finding of
“disproportionate” “pain behavior” during his palpatory examination. (Tr. 24, citing Tr. 398).
Dr. Onamusi’s conclusion, to which the ALJ cited, states in full that his “physical examination
revealed considerable pain behavior with minimal objective findings during examination
especially of the lower extremities.” (Tr. 398). The ALJ found Dr. Onamusi’s conclusion7 that
plaintiff can sit, stand, and walk frequently; lift up to 40 pounds occasionally; and frequently use
his upper extremities for motor tasks “somewhat consistent with the overall evidence.” (Tr. 23-
24).
“The Court cannot uphold an ALJ’s decision, even if there is enough evidence in the
record to support the decision, [where] the reasons given by the trier of fact do not build an
accurate and logical bridge between the evidence and the result.” Canty v. Comm’r of Soc. Sec.,
No. 2:15-cv-2221, 2016 WL 5957679, at *3 (S.D. Ohio Oct. 14, 2016) (citing Fleischer v.
Astrue, 774 F. Supp. 2d 875, 877 (N.D. Ohio 2011) (quoting Sarchet v. Chater, 78 F.3d 305, 307
(7th Cir. 1996)). See also Stephen D., 734 F. Supp. 3d 729, 741-42 (S.D. Ohio 2024) (quoting
Stacey v. Comm’r of Soc. Sec., 451 F. App’x 517, 519 (6th Cir. 2011) (Court must be able to
“trace the path of [the ALJ’s] reasoning.”). However, in examining the ALJ’s decision as a
whole, evaluation of a medical opinion within a broader discussion of the medical evidence
“suffices to ‘connect the dots.’” Brenda W. v. Comm’r of Soc. Sec., No. 2:24-cv-1128, 2025 WL
2750479, at *4 (S.D. Ohio Sept. 29, 2025) (quoting Dunlavy v. Comm’r of Soc. Sec., No. 24-
3333, 2024 WL 4558606, at *3 (6th Cir. Oct. 23, 2024)). See Booker R. v. Comm’r of Soc. Sec.,
7 In consecutive sentences within the same paragraph, the ALJ reiterated Dr. Onamusi’s opinion, the state
agency physicians’ opinion, and then stated,”[t]heir findings are somewhat consistent with the overall
evidence.” (Tr. 24). In the next sentence, the ALJ explained how he further limited plaintiff’s RFC,
specifically referencing Dr. Onamusi’s “own examination findings.” (Id.). When read in context, the
Court concludes that the ALJ’s use of the word “their” refers to both the state agency physicians and Dr.
Onamusi.
No. 3:22-cv-170, 2023 WL 4247312, at *4-5 (S.D. Ohio June 29, 2023) (“[M]eaningful judicial
review exists—even if the ALJ provided only a cursory or sparse analysis—if the ALJ made
sufficient factual findings elsewhere in the decision that support her conclusion.”); Lillian A. v.
O’Malley, No. 4:23-cv-4, 2024 WL 987571, at *2 (W.D. Ky. Mar. 7, 2024) (summarizing Crum,
660 F. App’x, 449, 457 (6th Cir. 2016) (“[I]t is sufficient for an ALJ’s reasons for determining
the consistency of a medical opinion to be found elsewhere in the decision[.]”)).
In this case, the ALJ’s evaluation of the consistency of Dr. Onamusi’s opinion with the
rest of the medical evidence is support by substantial evidence. The ALJ noted extensively the
chronic pain plaintiff experienced while also considering the imaging and other examinations
that found chronic mild to moderate conditions resulting in conservative treatment. His
explanation for finding Dr. Onamusi’s opinion “somewhat consistent” with the other medical
evidence is sufficient to connect the dots. (Tr. 24). Therefore, plaintiff’s assignment of error
will be overruled as to Dr. Onamusi.
d. State agency medical consultants Leslie Green, M.D., and Leon
Hughes, M.D.
State agency physician Leslie Green, M.D., reviewed plaintiff’s record initially in
September 2022. (Tr. 90-98). Based on her review of the record, Dr. Green concluded that
plaintiff is limited to lifting 20 pounds occasionally and 10 pounds frequently, sitting for a total
of 6 hours and standing/walking for 6 hours total during any given 8-hour workday. (Tr. 95).
Due to his knee and back pain, plaintiff can occasionally climb ramps and stairs; never climb
ladders, ropes, or scaffolds; and occasionally stoop, kneel, crouch, crawl, and balance. (Id.). Dr.
Green found plaintiff should avoid concentrated exposure of extreme cold and vibration and
avoid all exposure to hazards, including unprotected heights and operating heavy machinery.
(Tr. 96). State agency reviewing physician Leon Hughes, M.D., reviewed plaintiff’s file upon
reconsideration in April 2023 and affirmed Dr. Green’s assessment. (Tr. 105-06).
The ALJ found the assessments from Dr. Green and Dr. Hughes, “somewhat persuasive,”
finding their opinions are “generally consistent with the overall evidence, including other
opinion evidence.” (Tr. 24, citing to Dr. Onamusi’s report (Tr. 391-98)). However, the ALJ
noted that in “curbing the evidence in a light more favorable” to plaintiff, he reduced standing
and walking to only four hours per workday and included an allowance for the use of a cane for
ambulation. (Id.).
Plaintiff contends that the ALJ failed to evaluate the supportability and consistency of the
opinions of Drs. Green and Hughes. (Doc. 7 at PageID 1304-05). As discussed above, the Court
must evaluate the ALJ’s opinion as a whole to determine if the ALJ adequately explained his
supportability and consistency analysis. As for consistency, the ALJ’s discussion of plaintiff’s
other medical records, imaging results, and Dr. Onamusi’s findings adequately connect the dots
for the Court to find the ALJ’s “somewhat persuasive” finding supported by substantial
evidence. (Tr. 23-24).
Plaintiff accurately states that there are differences between Dr. Onamusi’s conclusions
and those of Drs. Green and Hughes. (Doc. 7 at PageID 1305). Specifically, Drs. Green and
Hughes concluded plaintiff could occasionally lift 20 pounds (Tr. 95, 105), while Dr. Onamusi
concluded plaintiff could occasionally lift up to 40 pounds (Tr. 398). Similarly, Drs. Green and
Hughes concluded that plaintiff can stand or walk (with normal breaks) up to about 6 hours per
day (Tr. 95, 105) while Dr. Onamusi concluded plaintiff could “stand or walk low end of
frequently” (Tr. 398). However, these minor differences fail to undermine the ALJ’s consistency
determination because he found the opinions of Drs. Green and Hughes only “somewhat
consistent with the overall evidence” and ultimately limited plaintiff’s RFC to occasionally
lifting or carrying 20 pounds and standing or walking for only 4 hours per day. (Tr. 22).
The ALJ’s supportability analysis presents a different question. “Supportability
emphasizes a medical source’s explanations: ‘The more relevant the objective medical evidence
and supporting explanations presented by a medical source are to support his or her medical
opinion(s) . . ., the more persuasive the medical opinions will be.’” James A. v. Comm’r of Soc.
Sec., No. 3:22-cv-207, 2023 WL 6307640, at *3 (S.D. Ohio Sept. 23, 2023) (quoting 20 C.F.R. §
404.1520c(c)(1)). “In other words, supportability addresses whether a medical professional has
sufficient justification for their own conclusions.” Id. at *4 (quoting Elizabeth A. v. Comm’r of
Soc. Sec., No. 2:22-cv-2313, 2023 WL 5924414, at *4 (S.D. Ohio Sept. 12, 2023)). “As one case
cogently explains, ‘It is not the role of a reviewing court to comb the record and imagine
manifold ways in which the factors could have been applied to the evidence that was presented.
The administrative adjudicator has the obligation in the first instance to show his or her work,
i.e., to explain in detail how the factors actually were applied in each case, to each medical
source.’” Id. (quoting Hardy v. Comm'r of Soc. Sec., 554 F.Supp.3d 900, 909 (E.D. Mich. Aug.
13, 2021)) (emphasis in original).
In this case, the ALJ’s entire supportability analysis consists of “state agency physicians,
Dr. Green and Dr. Hughes, reviewed the claimant’s file and evidence.” (Tr. 24). Nowhere in his
decision does the ALJ explain how he evaluated the supportability of the state agency
physicians’ opinions or identify the evidence on which they rely. Accordingly, the ALJ did not
satisfy the requirements of 20 C.F.R. § 404.1520c(c)(1). See Tina M. v. Comm’r of Soc. Sec.,
No. 2:24-cv-4252, 2025 WL 3158048, at *9 (S.D. Ohio Nov. 12, 2025) (“ALJ . . . also
specifically noted the state agency physicians’ references to records showing normal gait, normal
strength, and physical activities such as gardening all supported their opinions that plaintiff was
capable of medium-work.”).
The Court recognizes that, because state agency consultants do not possess their own
treatment records, it can be challenging to conduct a separate supportability analysis for their
medical opinions. See Tricia H. v. Comm’r of Soc. Sec., No. 2:23-cv-2090, 2024 WL 4010389,
at *7 (S.D. Ohio Aug. 30, 2024), report and recommendation adopted, 2024 WL 4216493 (S.D.
Ohio Sept. 17, 2024). However, “[i]f the consultant’s report clearly identifies the documents
relied upon to support their opinions, then the ALJ can conduct a supportability analysis that is
based on those documents.” Id.
The Commissioner contends that, because the ALJ found the opinions of Drs. Green and
Hughes only partially persuasive and because the ALJ imposed additional limitations beyond
those opined by the state agency physicians, any error in evaluating persuasiveness was
harmless. (Doc. 8 at PageID 1322) (“Plaintiff does not show how viewing the evidence in the
light most favorable to him and including additional limitations hurts his case.”). “[E]ven where
the ALJ’s decision is based on mistakes, this Court affirms those conclusions if the mistakes
constituted harmless error.” Keeton v. Comm’r of Soc. Sec., 583 F. App’x 515, 524 (6th Cir.
2014) (citing Berryhill v. Shalala, No. 92-5876, 4 F.3d 993, 1993 WL 361792, at *7 (6th Cir.
Sept. 16, 1993)). However, if the Court has “substantial doubt” as to whether the agency would
have made the same ultimate disability finding without the ALJ’s error, it should remand the
case. Berryhill, 1993 WL 361792, at *7. See also Rabbers, 582 F.3d at 654 (“[I]f an agency has
failed to adhere to its own procedures, we will not remand for further administrative proceedings
unless ‘the claimant has been prejudiced on the merits or deprived of substantial rights because
of the agency’s procedural lapses.’”) (quoting Connor v. United States Civil Serv. Comm’n, 721
F.2d 1054, 1056 (6th Cir. 1983)). Plaintiffs bear the burden to demonstrate harm. Elaine S. v.
Comm’r of Soc. Sec., No. 3:22-cv-240, 2023 WL 6290070, at *4 (S.D. Ohio Sept. 27, 2023)
(finding a supportability-analysis error harmless where plaintiff failed to identify evidence
conflicting with the ALJ’s conclusion regarding the state agency opinion).
In this case, the ALJ noted that Dr. Onamusi opined that plaintiff could sit, stand, and
walk frequently, and Drs. Green and Hughes concluded that plaintiff could perform a range of
light work. (Tr. 24, citing Tr. 90-98 and Tr. 100-08).8 However, “in curbing the evidence in a
light more favorable to” plaintiff, the ALJ reduced the RFC to standing and walking for only
four hours per workday and allowed for use of a cane for ambulation. (Tr. 24, 22). Although
plaintiff contends that the ALJ’s RFC failed to account for plaintiff’s mental health impairments
(which will be addressed below), plaintiff has failed to identify any evidence undermining the
ALJ’s conclusion that plaintiff could stand and walk for up to four hours per workday with use
of a cane. Accordingly, the ALJ’s inadequate supportability analysis of the state agency
physicians is harmless, and plaintiff’s assignment of error will be overruled as to Drs. Green and
Hughes.
2. The ALJ’s Evaluation of Plaintiff’s Mental Impairments in his RFC
Determination is Supported by Substantial Evidence.
Plaintiff next contends that the ALJ erred in failing to adequately account for plaintiff’s
mental health impairments throughout his residual functional capacity appraisal. (Doc. 7 at
PAGEID 1308-09). In determining a claimant’s RFC, an ALJ must consider all of the person’s
medically determinable impairments, including those that are deemed nonsevere. Napier, 127
F.4th at 1007 (quoting 20 C.F.R. §404.1545(a)(2)). Although there may be exceptions, the Sixth
8 Drs. Green and Hughes concluded that plaintiff could walk for “[a]bout 6 hours in an 8 hour workday.” (Tr. 96,
105).
Circuit has concluded that an ALJ adequately accounts for limitations in an RFC where
substantial evidence supports the ALJ’s finding that a claimant’s limitations were no more than
mild and the ALJ explicitly stated that he considered all of the claimant’s impairments, including
those found not to be severe. Id.
In this case, the ALJ found plaintiff’s medically determinable mental impairments to be
nonsevere at step two of the evaluation process. (Tr. 20). In support of this finding, the ALJ
accurately noted that: both the state agency reviewing consultants and the consultative examiner
found no more than mild limitations in any area; plaintiff had not regularly received mental
health treatment during the relevant period and had never been psychiatrically hospitalized;
plaintiff routinely denied altered mental status, depression, hallucinations, memory loss, or
suicidal ideation; during the consultative examination, he was fully oriented with normal
memory and no difficulty in understanding, remembering, or carrying out instructions,
maintaining attention, concentration, persistence, and pace to perform simple and multistep
tasks, and had an unremarkable social presentation; and plaintiff self-reported no history of
deterioration in response to work environments. (Id.). In addition, the ALJ stated that he
“considered all of the claimant’s medically determinable impairments, including those that are
not severe, when assessing [plaintiff’s] residual functional capacity.” (Id.).
Even if this explanation did not meet the standard endorsed in Napier, the ALJ here
reiterated in formulating the RFC that Drs. Hill and Souder found “no more than mild limitation
in any mental health area” which was consistent with the nature and frequency of plaintiff’s
mental health treatment and “examination findings of record.” (Tr. 24). Dr. Tanley’s
consultative examination findings revealed similarly nonsevere mental health impairments with
no more than mild limitations in any area. (Tr. 25). The only evidence plaintiff identifies as
requiring a mental health limitation in his RFC is the speculative statements Dr. Tanley
expressed that plaintiff “could potentially” be “slightly at risk” of mental health challenges “were
his mood problems to worsen.” (Doc. 7 at PageID 1308, citing Tr. 585)). However, the ALJ
expressly rejected limitations he considered speculative. (Tr. 20). As the ALJ adequately
accounted for plaintiff's mental impairments in his RFC, the RFC is supported by substantial
evidence, and plaintiff's final statement of error will be overruled.
Il. Conclusion
Based on the foregoing, plaintiff's statement of errors (Doc. 7) is OVERRULED, and
the Commissioner’s non-disability finding is AFFIRMED. IT IS THEREFORE ORDERED
that judgment be entered in favor of the Commissioner and this case is closed on the docket of
the Court.
Date: 8/28/2026 Haun K Xethevr-
Karen L. Litkovitz
United States Magistrate Judge
25