UNITED STATES DISTRICT COURT                            
                   DISTRICT OF MINNESOTA                                


Wahab B. A.,                         Case No. 23-CV-0816 (JFD)          

              Plaintiff,                                                

v.                                          ORDER                       

Martin J. O’Malley, Commissioner of                                     
the Social Security Administration,                                     

              Defendant.                                                


   Pursuant to 

(g), Plaintiff Wahab B. A. seeks judicial review of a 
final decision by the Commissioner of the Social Security Administration, which denied 
the Plaintiff’s applications for disability insurance benefits (“DIB”) and supplemental 
security  income (“SSI”).  In  Plaintiff’s  Motion  for  Summary  Judgment  (Dkt.  No.  9), 
Plaintiff  argues  that  the  administrative  law  judge  (“ALJ”)  who  authored  the  written 
decision erred in evaluating the severity of Plaintiff’s mental health impairments and in 
assessing Plaintiff’s residual functional capacity (“RFC”). In Defendant’s responsive Brief 
(Dkt. No. 17), Defendant asserts that the ALJ did not err in either respect and asks the 
Court to affirm the final decision. As set forth below, the Court agrees with Defendant and 
concludes that the ALJ did not err. The Court therefore denies Plaintiff’s Motion for 
Summary  Judgment  and  grants  the  relief  requested  in  Defendant’s  Brief.  The 
Commissioner’s final decision is affirmed.                                
I.   Background                                                           
   Plaintiff was 32 years old on the date of the Commissioner’s final decision. (See R. 
35, 36.)1 He has an 11th grade education and past relevant work as a housekeeper, laborer, 

packager, painter, and translator. (R. 538–39.) Plaintiff contends he has been disabled since 
March 30, 2017, due to a somatization disorder, depression, back pain, and shoulder pain. 
(R. 537, 588.)                                                            
   A.   Relevant Evidence                                               
   To be entitled to DIB, Plaintiff must show he was disabled before his insured status 

expired on June 30, 2020. (R. 15); Moore v. Astrue, 

 (8th Cir. 2009). The 
relevant period for DIB purposes is from January 1, 2017, the alleged onset-of-disability 
date, through June 30, 2020, the date Plaintiff was last insured. See Moore, 

. To be entitled to SSI, Plaintiff must show he was disabled between the date he filed 
his application, see Cruse v. Bowen, 

 (8th Cir. 1989) and the date of 

the ALJ’s decision, see Myers v. Colvin, 

 (8th Cir. 2013) (using the date 
of the ALJ’s decision on the SSI claim to mark the end of the relevant time period). Thus, 
the relevant period for SSI benefits is September 30, 2019, the date Plaintiff filed his SSI 
application (R. 115), through March 31, 2022, the date of the ALJ’s decision (R. 36). The 
Court limits its summation of evidence to the evidence relevant to these time periods and 

to the issues presented for judicial review.                              


1 The administrative record is filed at Dkt. No. 7. The record is consecutively paginated, 
and the Court cites to that pagination rather than ECF number and page.   
   Plaintiff attended an appointment with Dr. Esayas Okubamichael on September 28, 
2017, for treatment of shoulder and back pain, loss of interest, and fatigue. (R. 787.) The 

doctor described Plaintiff’s psychiatric symptoms as “chronic fatigue and loss of interest. 
Feels depressed.” (R. 788.) Plaintiff’s PHQ-9 score was 20.2 (R. 789.) Dr. Okubamichael’s 
objective psychiatric findings were “[w]ell-oriented, normal speech, normal cognition and 
insight,  slightly  depressed  mood.”  (R.  788.)  Dr.  Okubamichael  referred  Plaintiff  for 
behavioral health treatment. (R. 789.)                                    
   On October 31, 2017, Plaintiff consulted with Dr. Ryan Engdahl about his pain and 

depression.  Dr. Engdahl recorded a PHQ-9 score of 20. (R.  657.) The mental status 
examination was unremarkable. (R. 658.) In particular, Plaintiff was not anxious but was 
alert and oriented, and he had a full range of affect, a euthymic mood, logical thought 
processes and content, good insight and judgment, appropriate tolerance to frustration, and 
a good memory. (R. 658–59.) Dr. Engdahl recommended that Plaintiff follow up with his 

prescribing doctor to identify the most effective medications, attend physical therapy for 
his physical issues, and meet again with Dr. Engdahl to address his mood and stress 
management. (R. 657.)                                                     
   Plaintiff returned to Dr. Engdahl on January 2, 2018. Plaintiff denied having mental 
health issues but said his back pain was stressful. (R. 660.) Dr. Engdahl reported findings 

similar to the mental status examination in October 2017. (R. 661.) Plaintiff’s PHQ score 

2  “PHQ”  is  an  acronym  for  Patient  Health  Questionnaire.  PHQ-9  questionnaires  are 
completed independently by a patient and are intended to reflect subjective, self-reported 
symptoms. See Amy R. v. Saul, No. 19-CV-1508 (KMM), 

, at *1 (D. 
Minn. June 10, 2020).                                                     
was 13, indicating moderate depression. (R. 25, 663.) In March 2018, Plaintiff told Dr. 
Engdahl that back pain was his main stressor and described his current pain as a “1.5.” (R. 

662.) He told Dr. Engdahl he was not interested in pursuing physical therapy. His PHQ 
score was 6, indicating mild depression. (R. 25, 663.)                    
   Plaintiff attended an appointment with Dr. Adei Shaqra on June 7, 2019. He said his 
pain was “half a percent” and that one Tylenol taken in the morning lasted all day. (R. 723.) 
The physical examination was unremarkable, although Dr. Shaqra noted that Plaintiff’s 
affect was flat and the doctor was not sure how much Plaintiff understood him. (R. 724.) 

Dr. Shaqra thought Plaintiff “may benefit from a functional capacity assessment” and 
would “certainly need a neuropsych evaluation” for cognitive functioning. (R. 725.)  
   In 2020, four state agency psychological consultants (Drs. Bonnie Katz, Rohini 
Mendonca, Jeffrey Boyd, and Gregory H. Salmi) each reviewed the Plaintiff’s medical 
records and other relevant evidence. They each opined that Plaintiff was moderately limited 

in each of the four broad areas of mental functioning: (1) understanding, remembering, and 
applying information; (2) concentrating, persisting, and maintaining pace; (3) interacting 
socially; and (4) adapting or managing himself. (R. 121, 136, 156, 171.)  
   An unsigned “Behavioral Health Psychological Assessment” reflecting assessments 
in February and April 2021 is part of the record. (R. 1025–33.) The assessor’s mental status 

examination findings included good cooperation, normal speech, good mood, a restricted 
and flat affect, logical thoughts, no anxious disturbances, good alertness and orientation, 
difficulties with short-term and long-term memory, and average judgment and insight. (R. 
1029.)  The  examiner  diagnosed  Plaintiff,  in  relevant  part,  with  a  mild  cognitive 
impairment, a major depressive disorder that was recurrent but in partial remission, and an 
unspecified anxiety disorder. (R. 1032.) The examiner also administered several tests, on 

which Plaintiff performed within the less-than-one-percentile group across all cognitive 
domains. (R. 1031.)                                                       
   In  March  2021,  the  ALJ  asked  the  Cooperative  Disability  Investigations  Unit 
(“CDIU”) of the Social Security Administration’s Office of the Inspector General to 
investigate whether Plaintiff was malingering. (R. 618.) While conducting surveillance, an 
investigator observed Plaintiff and another person walk more than 1.5 miles in 90-degree 

heat to a residence, then back to Plaintiff’s residence, stopping along the way at a gas 
station and liquor store. (R. 624.) At that time, Plaintiff was living in a residential boarding 
facility for individuals who needed psychiatric care, were chemically dependent, or needed 
transitional housing. (R. 625.) The resident nurse told the investigator that Plaintiff did not 
fit any of those criteria. The nurse also said that Plaintiff “required minimal care and was 

very independent and capable of performing all of his daily needs.” (R. 626.)  
   B.   Procedural History                                              
   Plaintiff’s DIB and SSI applications were denied at both the initial review and 
reconsideration stages. He requested an administrative hearing before an ALJ, and that 
hearing took place on November 12, 2020. (See R. 12.) The hearing was continued to retain 

a medical expert and to allow Plaintiff to undergo a neuropsychological evaluation. (See 
R. 12.) A supplemental hearing occurred on May 26, 2021. (See R. 12.) An impartial 
medical expert, Dr. Michael Carney, appeared and testified, but that hearing was continued 
so that Dr. Carney could review newly submitted evidence. (See R. 12.) Dr. Carney is a 
licensed clinical psychologist. (R. 68.) A third hearing was convened on November 2, 
2021. (See R. 12.) Dr. Carney again appeared and testified, as did Sheila Capizzi, a 

vocational expert. (See R. 12–13.) The ALJ held the hearing open for 14 days to receive 
new evidence, and both the CDIU report and a Professional Statement of Need form (R. 
1196–1200) were received. A fourth hearing was held on March 17, 2022. (See R. 13.)  
   Relevant to the issues presented for judicial review, at the November 2021 hearing 
Dr. Carney considered whether Plaintiff’s impairments met or equaled the “listings” for a 
somatic symptom disorder, depressive disorder, or neurodevelopmental disorder.3 (R. 69–

70.) The doctor testified that Plaintiff’s case was “very problematic” in making that 
determination because “he certainly claims he’s got these ongoing pains but . . . they could 
find no organic basis, no [etiology] for these pains and yet nonetheless he reports them and 
certainly they think that they are disabling.” (R. 70.) Dr. Carney further testified that no 
physical findings supported Plaintiff’s claim of inability to work. (R. 70.) Dr. Carney 

pointed out that the neuropsychological examination results (that Plaintiff was in the less-
than-one-percentile group for every test) were either based on Plaintiff’s subjective reports 
or were not consistent with mild scores and normal mental status examinations documented 
throughout his medical records. (R. 70–71.) In particular, no provider had found that 
Plaintiff was slow, had borderline intellectual functioning, or had an intellectual disability. 


3 The “listings,” also known as the Listing of Impairments, set the criteria the SSA uses in 
determining whether a particular impairment “is severe enough to prevent an individual 
from doing any gainful activity, regardless of his or her age, education, or work experience” 
or, put simply, makes the claimant disabled. 

(a), 404.1520(a)(4)(iii), 
416.925(a), 416.920(a)(4)(iii); see generally 20 C.F.R. pt. 404, subpt. P, app. 1. 
(R. 71.) Nor were the neuropsychological examination results consistent with Plaintiff’s 
ability to work in the past, even though that work was unskilled. (R. 72–73.) If the scores 

were accurate, Dr. Carney testified, Plaintiff would be “nonfunctional basically.” (R. 73.)  
   On March 31, 2022, the ALJ issued a written decision finding Plaintiff not disabled. 
(R. 12–36.) The ALJ followed the familiar five-step sequential analysis outlined in 

 and 416.920. At each step, the ALJ considered whether Plaintiff was 
disabled based on the criteria of that step. If he was not, the ALJ proceeded to the next step. 
See 

(a)(4), 416.920(a)(4).                           

   The ALJ first determined that Plaintiff had not engaged in substantial gainful 
activity since the alleged onset date. (R. 15.) At the second step of the sequential analysis, 
the ALJ found that Plaintiff had the following severe impairments: somatic symptom 
disorder,  major  depressive  disorder,  cannabis  use  disorder,  and  neurodevelopmental 
disorder. (R. 15.)                                                        

   At step three, the ALJ concluded that Plaintiff’s impairments did not meet or 
medically equal the severity of an impairment listed in 20 C.F.R. part 404, subpart P, 
appendix I. (R. 17.) The ALJ considered listings for neurocognitive disorders (Listing 
12.02); depressive, bipolar, and related disorders (Listing 12.04); somatic symptom and 
related  disorders  (Listing  12.07);  and  trauma-  and  stressor-related  disorders  (Listing 

12.15). (R. 17.) None of the listings were met or medically equaled because Plaintiff was 
only “moderately” limited in his abilities to understand, remember, or apply information; 
to interact with others; to concentrate, persist, or maintain pace; and to adapt or manage 
himself.4 (R. 17–19.)                                                     

   Before  proceeding  to  step  four,  the  ALJ  assessed  Plaintiff’s  RFC,  which  is  a 
measure  of  “the  most  [he]  can  still  do  despite  [his]  limitations.”  

(a)(1), 416.945(a)(1). The ALJ’s RFC assessment included consideration of 
the  medical  opinion  evidence.  The  ALJ  found  Dr.  Carney’s  opinion  persuasive,  the 
opinions  of  the  state  agency  psychological  consultants  partially  persuasive,  and  the 
neuropsychological examination findings not persuasive. (R. 33–34.) Ultimately, the ALJ 

found that Plaintiff                                                      
   has the residual functional capacity to perform a full range of work at all 
   exertional  levels  but  with  the  following  nonexertional  limitations:  The 
   claimant is limited to simple routine repetitive tasks and may have occasional 
   superficial contact with others where superficial is rated no lower than an 8 
   on the Selected Characteristics of Occupations’ people rating.       

(R. 21.) With this RFC, the ALJ concluded, Plaintiff could perform his past work as a 
housekeeper or packager. (R. 34.) Consequently, Plaintiff was not disabled. (R. 36.)  
   The Appeals Council denied Plaintiff’s request for review of the ALJ’s decision. 
(R. 1.) This made the ALJ’s decision the final decision of the Commissioner for the purpose 
of judicial review.                                                       



4 To meet or medically equal one of these listings under the criteria applied by the ALJ (the 
“paragraph B” criteria), Plaintiff’s impairments must have caused one “extreme” limitation 
or two “marked” limitations. 20 C.F.R. pt. 404, subpt. P, app. 1.         
II.  Standard of Review                                                   
   Judicial review of the Commissioner’s denial of benefits is limited to determining 

whether substantial evidence in the record as a whole supports the decision, 

(g), or whether the ALJ committed an error of law, Nash v. Commissioner, Social 
Security Administration, 

 (8th Cir. 2018). “Substantial evidence is less 
than a preponderance but is enough that a reasonable mind would find it adequate to 
support the Commissioner’s conclusion.” Krogmeier v. Barnhart, 

 
(8th Cir. 2002) (citing Prosch v. Apfel, 

 (8th Cir. 2000)). The Court 

must  examine  “evidence  that  detracts  from  the  Commissioner’s  decision  as  well  as 
evidence that supports it.” 

 (citing Craig v. Apfel, 

 (8th Cir. 2000)). 
The Court may not reverse the ALJ’s decision simply because substantial evidence would 
support a different outcome or because the Court would have decided the case differently. 

 (citing Woolf v. Shalala, 

 (8th Cir. 1993)). In other words, if it is 

possible to reach two inconsistent positions from the evidence and one of those positions 
is that of the Commissioner, the Court must affirm the decision. Robinson v. Sullivan, 

 (8th Cir. 1992).                                            
   A claimant has the burden to prove disability. See Roth v. Shalala, 

 
(8th Cir. 1995). To meet the definition of disability for DIB and SSI, the claimant must 

establish that he is unable “to engage in any substantial gainful activity by reason of any 
medically determinable physical or mental impairment which can be expected to result in 
death or which has lasted or can be expected to last for a continuous period of not less than 
12  months.”  

(d)(1)(A),  1382c(a)(3)(A).  The  disability,  not  just  the 
impairment, must have lasted or be expected to last for at least twelve months. Titus v. 
Sullivan, 

 (8th Cir. 1993).                                

III.  Discussion                                                          
   Plaintiff raises several points of error in support of his arguments that the ALJ erred 
in  evaluating  the  severity  of  Plaintiff’s  mental  health  impairments  and  in  assessing 
Plaintiff’s RFC. The Court addresses each in turn below.                  
   A.   Substantial  evidence  supports  the  ALJ’s  finding  that  Plaintiff  had 
        relatively few symptom reports and unremarkable or normal mental 
        status examination findings.                                    

   Plaintiff first takes issue with the ALJ’s finding that Plaintiff had relatively few 
symptom reports and unremarkable or normal mental status findings. (Pl.’s Mem. at 3.) 
Plaintiff identifies several pages in the record that contain evidence contrary to the ALJ’s 
finding. For example, Plaintiff cites to an exhibit documenting a PHQ-9 score of 20 and 
points out that such a score indicates “severe depression.” (Pl.’s Mem. at 3 (citing R. 657).) 
Indeed, the ALJ acknowledged the PHQ-9 score of 20, but the ALJ also noted several other 
PHQ-9 scores in the range between 6 and 13, which indicated only mild to moderate 
depression. (R. 25, 29–30.) In determining that Plaintiff’s PHQ-9 scores, on balance, 
indicated  no  more  than  mild  depression,  the  ALJ  referred  to  treatment  notes  that 
documented relatively normal or insignificant mental status examination findings and 

progress notes that reflected Plaintiff’s belief that he could not work if he had any amount 
of pain. (R. 29–30.)                                                      
   Other evidence, specifically mentioned by the ALJ in his written decision, also 
supports  the  ALJ’s  finding  that  Plaintiff  had  relatively  few  symptom  reports  and 
unremarkable or inconsistent mental status examination findings. Significantly, Plaintiff’s 
providers could not find a cause for his pain, nor did physical findings support an inability 

to work. (R. 22.) Plaintiff indicated more than once that he needed to be pain-free in order 
to  work.  (R.  24–25,  27.)  Plaintiff  attributed  his  mental  impairments  to  pain,  yet  he 
described his pain as minimal: either less than one percent or a “1.5.” (R. 25–26.) Mental 
status  examinations  findings  were  frequently  normal,  including  intact  memory,  good 
memory recall, normal cognition, and good attention and concentration. (R. 24–27; see, 
e.g., 658–59, 661, 664–65, 668–69, 673, 677, 681–82, 685–86, 691–92, 696, 809, 816, 

844–45, 870, 937.) In identifying evidence to the contrary, Plaintiff essentially asks this 
Court to reweigh the evidence, which the Court may not do. Naber v. Shalala, 

 (8th Cir. 1994) (“We do not reweigh the evidence or review the factual record de 
novo.”).                                                                  
   It is clear from the ALJ’s decision that he was aware of the inconsistencies and 

conflicting statements in the record concerning Plaintiff’s symptoms and mental state. It 
was the ALJ’s duty to resolve those conflicts. Richardson v. Perales, 

 
(1971). Substantial evidence supports the ALJ’s finding that Plaintiff had relatively few 
symptom reports and unremarkable or inconsistent mental status examination findings. 
   B.   The  ALJ  did  not  disregard  evidence  from  Drs.  Shaqra  and 
        Okubamichael.                                                   

   Relatedly, Plaintiff contends that the ALJ disregarded certain evidence from Drs. 
Shaqra and Okubamichael. (Pl.’s Mem. at 4.) In particular, Plaintiff notes that Dr. Shaqra 
wrote that Plaintiff might need a functional capacity assessment and a neuropsychological 
evaluation, and that Plaintiff had a flat affect and may not have understood Dr. Shaqra. The 
ALJ did not overlook this evidence. Rather, the ALJ specifically noted Dr. Shaqra’s finding 

of a flat affect but also cited other findings of a full or normal affect. (R. 24–27.) The ALJ 
also considered Dr. Shaqra’s comment that he was not sure how much of their conversation 
Plaintiff understood. (R. 26.) With respect to Dr. Shaqra’s belief that Plaintiff might need 
a functional capacity assessment and a neuropsychological evaluation, the ALJ recessed 
Plaintiff’s  first  hearing  to  obtain  a  neuropsychological  report,  and  the  state  agency 
consultants conducted both physical and mental functional capacity assessments. (R. 122–

27, 158–62.) Not only did the ALJ consider the evidence from Dr. Shaqra at issue, but 
Plaintiff has not explained how the evidence would have required the ALJ to reach a 
different result. See Fentress v. Berryhill, 

 (8th Cir. 2017). 
   Similarly, Plaintiff contends that the ALJ disregarded Dr. Okubamichael’s findings 
that Plaintiff had chronic fatigue, loss of interest, and feelings of depression. (Pl.’s Mem. 

at 4.) To the contrary, the ALJ referred to this medical record in the written decision; noted 
Plaintiff’s self-reports of back pain, fatigue, and loss of interest; and acknowledged a 
mental status examination finding of a slightly depressed mood. (R. 24 (citing R. 787–88).) 
As with Dr. Shaqra, Plaintiff has not explained how this evidence from Dr. Okubamichael  
would have required a different outcome.                                  

   C.   The ALJ did not err by relying on evidence from nonacceptable medical 
        sources.                                                        

   Plaintiff next faults the ALJ for relying on evidence from Elizabeth Perdue, a 
registered  nurse,  and  Colette  Neron  Ellenbecker,  a  licensed  social  worker,  without 
acknowledging that these individuals were not “acceptable medical sources.”5 (Pl.’s Mem. 
at 5, 6.) Ms. Perdue periodically checked-in with Plaintiff concerning his care. (E.g., R. 

929.) In February 2022, Ms. Ellenbecker conducted an annual diagnostic assessment of 
Plaintiff’s mental status and level of functioning to ascertain his need and eligibility for 
Adult Rehabilitative Mental Health Services (“ARMHS”). (R. 1162–70.) Plaintiff further 
contends the ALJ should not have relied on evidence from Rachel Geier, a licensed social 
worker, even though the ALJ acknowledged she was not an acceptable medical source. Ms. 
Geier consulted with Plaintiff for treatment of depression and stress. (E.g., R. 713.)  

   The ALJ did not err by relying on evidence from Ms. Perdue, Ms. Ellenbecker, and 
Ms. Geier. Although only an acceptable medical source can provide objective medical 
evidence to establish a physical or mental impairment, see 

, the ALJ 
may consider statements from other medical sources and from nonmedical sources in 
assessing a claimant’s RFC, see 

(a)(3), (e). The ALJ may also 

consider statements from “nonacceptable” medical sources and nonmedical sources in 
evaluating symptoms such as pain. 

(a), 416.929(a).   
   Plaintiff also points out that the ALJ did not acknowledge notations from Ms. 
Perdue such as “confused,” “loose association,” and “unable to assess.” (Pl.’s Mem. at 5.) 
Plaintiff has not shown, however, how this evidence would have required the ALJ to reach 




5 An “acceptable medical source” includes licensed physicians, licensed psychologists, 
licensed advanced practice registered nurses, and licensed physician assistants, among 
others. 

(a), 416.902(a).                             
a different result. In addition, an ALJ need not discuss each notation in every treatment 
record.                                                                   

   D.   The ALJ did not find that Plaintiff had no mental impairments.  

   Plaintiff asks in his memorandum, perhaps rhetorically, “if he didn’t have mental 
health issues, why wasn’t he discharged?” (Pl.’s Mem. at 7.) The ALJ did not determine, 
however, that Plaintiff had no mental health issues or impairments. To the contrary, the 
ALJ determined that Plaintiff had a somatic symptom disorder, major depressive disorder, 
and neurodevelopmental disorder, and that these disorders were severe impairments. (R. 
15.) The ALJ also found that, as a result of these impairments, Plaintiff should be limited 
to simple, routine, and repetitive tasks and to only occasional and superficial contact with 
others. (R. 21.) The ALJ did not suggest that Plaintiff had no mental impairments or should 
cease treatment.                                                          
   E.   The ALJ did not disregard evidence from Drs. Gamaliel Ferrer and 
        Michael Balfanz.                                                

   Plaintiff refers to treatment records from Drs. Gamaliel Ferrer and Michael Balfanz, 
who treated Plaintiff for physical conditions, that also mention Plaintiff’s mental health 
and intellectual abilities. (Pl.’s Mem. at 7.) In February 2021, Dr. Ferrer completed a 
Minnesota  Department  of  Human  Services  Professional  Statement  of  Need  form  for 
Plaintiff to receive housing support and stabilization services. (R. 1112–13.) Dr. Ferrer 
checked  the  box  “mental  health”  for  the  required  “disabling condition”  and  the  box 
indicating that the condition would last at least one year. The form explained that a 

disability determination or formal diagnostic assessment was not required, and Dr. Ferrer 
provided no other information about the “disabling condition.” In June 2019, Dr. Balfanz, 
a chiropractor, remarked that Plaintiff was “having a bit of difficulty communicating with 

me due to language as well as intellectual ability.” (R. 702.)            
   Plaintiff has not explained how this evidence would have required the ALJ to reach 
a different result. The form completed by Dr. Ferrer is conclusory and lacks any supporting 
findings or details. Dr. Balfanz’s remark appears to be an isolated one; lacks supporting 
findings or details; and is inconsistent with numerous other treatment records cited by the 
ALJ in the decision, documenting Plaintiff’s ability to communicate effectively (R. 18, 24, 

25, 27, 31, 34). In addition, an ALJ is not required to discuss each and every treatment note 
in the record, and these conclusory records are of tangential relevance to Plaintiff’s mental 
impairments. Finally, to the extent these records could be considered substantial evidence, 
simply because they could support a different outcome does not mean the ALJ’s decision 
is not supported by substantial evidence.                                 

   F.   The ALJ properly considered the CDIU report.                    

   Plaintiff asserts that the CDIU report did not really address his mental health 
impairments and thus the ALJ should not have considered it. (Pl.’s Mem. at 9.) The ALJ 
referred  Plaintiff’s  case  to  the  CDIU  to  resolve  conflicting  evidence  in  the  record 
concerning  Plaintiff’s  pain.  The  ALJ  recounted  several  of  the  investigative  findings 
including Plaintiff’s ability to walk for extended periods of time, ability to spend time with 
others, and ability to function essentially independently at his residential boarding facility. 
(R. 30–31.) The CDIU report was directly relevant to whether Plaintiff could function 
better than he claimed. The report supports the ALJ’s RFC findings that Plaintiff could 
work at all exertional levels; with limitations to simple, routine, and repetitive tasks; and 
with occasional and superficial contacts with others. The CDIU report also supports the 

ALJ’s  determination  that  Plaintiff’s  statements  about  the  intensity,  persistence,  and 
limiting effects of his symptoms—including pain—were not consistent with the medical 
and other evidence of record. And, finally, the CDIU report is inconsistent with the 
neuropsychological examination results, which, if believed, indicated that Plaintiff was 
basically nonfunctional.                                                  
   Plaintiff  also  argues  that  the  resident  nurse  had  indicated  on  a  Professional 

Statement of Need form in March 2020 that Plaintiff had a “mental illness” and would need 
assistance for a year or more, which is inconsistent with her comments to the investigator 
in March 2021 as reflected in the CDIU report. The Professional Statement of Need form 
is conclusory, however, and lacks any supporting findings or details. (R. 1110–11.) The 
nurse simply checked the box for “mental illness” and other boxes, without providing any 

explanation, documentation, or findings. Moreover, as with the form completed by Dr. 
Ferrer, Plaintiff has not explained how the March 2020 form would have required the ALJ 
to reach a different result. The form is inconsistent with other evidence of record, including 
the nurse’s statements to the investigator, and it is the ALJ’s duty to resolve inconsistencies 
in the record. See Perales, 

. Finally, to the extent the form could be 

considered  substantial  evidence,  it  does  not  overcome  the  substantial  evidence  that 
supports the ALJ’s decision.                                              
   G.   The ALJ properly resolved inconsistencies about Plaintiff’s functioning. 

   Plaintiff argues that the ALJ’s finding about Plaintiff’s ability to complete tasks is 
inconsistent with a Function Report that Plaintiff filled out. (Pl.’s Mem. at 9.) The ALJ 
found  that  Plaintiff  “reported  difficulty  with  concentration,  but  did  not  indicate  any 
difficulty completing tasks.” (R. 18–19.) Plaintiff concedes that he did not check the box 
on the Function Report that indicated problems completing tasks. (R. 569.) Plaintiff points 
out, however, that he answered “No” to the question, “Do you finish what you start?” (R. 
569.)                                                                     

   It was the ALJ’s duty to resolve inconsistencies in the evidence. See Perales, 

. To the extent Plaintiff’s responses were inconsistent, the ALJ did not err by 
finding  that  Plaintiff  did  not  have  problems  completing  tasks.  Substantial  evidence 
supports this finding, not the least of which are Plaintiff’s own responses on the Function 
Report. Other substantial evidence, cited by the ALJ in the written decision, includes 

Plaintiff’s  abilities  to  prepare  simple  meals,  do  his  own  laundry,  and  use  public 
transportation; numerous mental status examination findings of no significant issues with 
concentration; and the opinions of state agency psychological consultants who found that 
Plaintiff could perform concrete, simple, short-cycle tasks. (R. 18–19, 32.) In addition, the 
ALJ found that Plaintiff’s statements about the intensity, persistence, and limiting effects 

of his symptoms were not consistent with the objective medical evidence. (R. 22.) This 
would include Plaintiff’s statement that he cannot finish what he starts. Finally, the ALJ 
did not conclude that Plaintiff had no limitation in his ability to complete tasks. Rather, the 
ALJ concluded that Plaintiff’s ability to concentrate, persist, and maintain pace, which 
would include his ability to complete tasks, was moderately limited. The ALJ therefore 
limited Plaintiff to simple, routine, repetitive tasks in the RFC assessment. The Court 

concludes that the ALJ did not err in resolving inconsistencies about Plaintiff’s functioning.  
   H.   The ALJ did not fail in his duty to fully and fairly develop the record.  

   Plaintiff submits that the ALJ erred in his duty to fully and fairly develop the record. 
Specifically,  Plaintiff  contends  that  the  ALJ  should  have  ordered  a  post-hearing 
neuropsychological evaluation by a consultative examiner to address Dr. Carney’s concern 
with the lack of physical findings to support Plaintiff’s claims of pain and inability to work 
and  to  address  the  ALJ’s  skepticism  about  the  accuracy  of  the  neuropsychological 
evaluation findings. (Pl.’s Mem. at 10–11.)                               
   The Court finds that the ALJ did not err. The ALJ’s duty to fully and fairly develop 
the record is not limitless. “An ALJ is required to obtain additional medical evidence if the 
existing medical evidence is not a sufficient basis for a decision.” Naber v. Shalala, 

 (8th Cir. 1994) (citation omitted). On the other side of the coin, “an ALJ is 
permitted to issue a decision without obtaining additional medical evidence so long as other 
evidence in the record provides a sufficient basis for the ALJ’s decision.” 

 (citation 
omitted).                                                                 
   Here, the existing medical record provided a sufficient basis for the ALJ’s decision. 

Before the first hearing, the record already contained numerous treatment records and 
progress notes, medical source opinions, a function report from Plaintiff, and evidence 
from  non-medical  sources.  The  ALJ  postponed  three  hearings  to  receive  additional 
evidence.  During  those  postponements,  the  ALJ  allowed  Plaintiff  to  submit  a 
neuropsychological report, arranged for testimony from a medical expert, and gave the 
medical expert time to review new evidence. After the fourth hearing, the ALJ held open 

the record and received the CDIU report and a Professional Statement of Need form.  
   With particular respect to Dr. Carney’s concern with the lack of physical findings 
that would support Plaintiff’s claims of pain and inability to work, the ALJ effectively 
resolved that concern by finding Plaintiff’s statements about his pain and ability to work 
inconsistent with the objective medical evidence. The ALJ recounted evidence of normal 
or unremarkable physical and mental status examinations, Plaintiff’s belief that he would 

need to be pain-free in order to work, Plaintiff’s lack of follow-through with physical 
therapy, and the CDIU report that contained no observations of pain or other difficulties, 
among other evidence. (R. 24–31.) The ALJ explicitly found Plaintiff’s “exam findings 
and providers’ objective observations do not support the level of alleged limitations.” (R. 
22.) It is not likely that another neuropsychological evaluation would have provided the 

lacking physical findings.                                                
   The ALJ resolved his own skepticism about the accuracy of the neuropsychological 
evaluation by finding the report not persuasive. (R. 33.) The ALJ noted that the report was 
in direct contrast with normal mental status examinations, “all other treating providers’ 
objective observations,” Plaintiff’s ability to work in the past, and the CDIU report. (R. 

33–34.) If the findings in the neuropsychological evaluation were accepted, Plaintiff would 
be essentially non-functional, and that lack of functioning was starkly inconsistent with 
nearly all of the evidence of record.                                     
   In sum, the Court concludes the ALJ met his duty to fully and fairly develop the 
record.                                                                   

   I.   The ALJ did not err by relying on Dr. Carney’s testimony.       
   Plaintiff argues that the ALJ should not have relied on Dr. Carney’s testimony 
because Dr. Carney “waxed and waned” on Plaintiff’s ability to maintain concentration, 
pace, and persistence. (Pl.’s Mem. at 12.) It is the ALJ’s role to assess a claimant’s RFC. 
See 

, 416.946. Based on the ALJ’s consideration of the evidence, he 
determined that Plaintiff had no more than moderate limitations in his ability to maintain 

concentration, pace, and persistence. The ALJ noted that Dr. Carney “deferred to opine as 
to limitations in concentrating, persisting, or maintaining pace,” but the ALJ then supported 
the moderate limitation in this area with medical evidence from Plaintiff’s providers and 
the opinions of the state agency psychological consultants.               
   Plaintiff also submits that Dr. Carney “struggled to understand the level of support” 

that he had at his residential boarding facility. (Pl.’s Mem. at 11.) The support Plaintiff 
received, however, is beside the point. The relevant inquiry is what activities Plaintiff could 
perform, and there is ample evidence that Plaintiff could care for himself, make simple 
meals, do his own laundry, shop for himself, walk for extended periods of time without 
visible pain or difficulty, socialize with others, use public transportation, and make his own 

medical appointments. The nurse at the facility said that Plaintiff required minimal care 
and was very independent.                                                 
   Plaintiff next suggests that Dr. Carney should not have relied on the Function Report 
because the form was completed by an individual named Billy Anderson and there is no 
proof that the answers came from Plaintiff. (Pl.’s Mem. at 11–12.) Plaintiff was not 
troubled by Billy Anderson’s involvement, however, when he asked the Court to take into 

account the answer “No” to the question, “Do you finish what you start?” on the Function 
Report. Moreover, Plaintiff neglects to mention that Billy Anderson was his non-attorney 
representative at that time. (See R. 209.) The Court finds this argument unconvincing.  
   J.   The  ALJ  properly  considered  the  neuropsychological  examination 
        report.                                                         

   Plaintiff  takes  issue  with  the  ALJ’s  failure  to  incorporate  the  results  of  the 
neuropsychological examination into the RFC and hypothetical question posed to the 
vocational  expert.  (Pl.’s  Mem.  at  15.)  The  Court  has  already  touched  on  the  ALJ’s 
determination  that  the  neuropsychological  evaluation  report  was  not  persuasive,  but 
expands that discussion here.                                             
   Title 

.1520c and 416.920c set forth the standards under which an 
ALJ considers medical opinion evidence. An ALJ considers how “persuasive” an opinion 
is according to five factors: supportability, consistency, relationship with the claimant, 
specialization,  and  any  other  relevant  factors.  

.1520c(c)(1)–(5), 

416.920c(c)(1)–(5). The “most important factors” are supportability and consistency. 

.1520c(b)(2), 416.920c(b)(2). The ALJ “may, but [is] not required to,” 
explain  how  the  remaining  factors  were  considered.  

.1520c(b)(2), 
416.920c(b)(2). The regulatory language pertaining to supportability provides that “[t]he 
more relevant the objective medical evidence and supporting explanations presented by a 

medical source are to support his or her medical opinion(s) or prior administrative medical 
finding(s),  the  more  persuasive  the medical  opinions  or  prior  administrative medical 
finding(s)  will  be.”  

.1520c(c)(1),  416.920c(c)(1).  In  evaluating 

consistency, “[t]he more consistent a medical opinion(s) or prior administrative medical 
finding(s) is with the evidence from other medical sources and nonmedical sources in the 
claim, the more persuasive the medical opinions or prior administrative medical finding(s) 
will be.” 

.1520c(c)(2), 416.920c(c)(2). In other words, supportability 
looks to how well the medical source justifies their own opinion, and consistency looks to 
how well the medical source’s opinion fits with evidence from other sources.  

   The Court finds that the ALJ adequately considered the persuasiveness of the 
neuropsychological examination report and did not err in deeming it not persuasive. The 
ALJ exhaustively detailed how the findings in the report were inconsistent with evidence 
from other medical and nonmedical sources, including mental status examination findings, 
the CDIU report, treating providers’ objective observations, frequently mild PHQ-9 scores, 

and Plaintiff’s ability to work in the past. (R. 33–34.)                  
   The ALJ also found the report was not supported by the examiner’s own mental 
status  examination  findings,  which  noted  that  Plaintiff  was  dressed  and  groomed 
appropriately, walked with a normal and independent gait, had good eye contact, was 
cooperative, spoke normally, had no movement abnormalities, appeared to be in a good 

mood, had logical thought processes and content, displayed no loosening associations, 
showed  no  anxious  disturbances,  was  alert  and  fully  oriented,  had  developmentally 
appropriate attention and concentration, could describe recent events, showed an average 
fund of knowledge, used developmentally appropriate language, and had average insight 
and judgment. (R. 33.) Nor was the report supported by evidence of an intervening head 
trauma or other significant event that would explain such a grave degree of cognitive 

decline. (R. 34.)                                                         
IV.  Conclusion                                                           
   The Commissioner’s final decision is supported by substantial evidence in the 
record as a whole, and the ALJ committed no error of law. Accordingly, IT IS HEREBY 
ORDERED THAT:                                                             
1.  Plaintiff’s Motion for Summary Judgment (Dkt. No. 9) is DENIED.     

2.  The relief requested in Defendant’s Brief (Dkt No. 17) is GRANTED, and the 
   Commissioner’s final decision is AFFIRMED.                           

LET JUDGMENT BE ENTERED ACCORDINGLY.                                      


Date: June 17, 2024             s/  John F. Docherty                    
                                JOHN F. DOCHERTY                        
                                United States Magistrate Judge          

                UNITED STATES DISTRICT COURT                            
                   DISTRICT OF MINNESOTA                                


Wahab B. A.,                         Case No. 23-CV-0816 (JFD)          

              Plaintiff,                                                

v.                                          ORDER                       

Martin J. O’Malley, Commissioner of                                     
the Social Security Administration,                                     

              Defendant.                                                


   Pursuant to 

(g), Plaintiff Wahab B. A. seeks judicial review of a 
final decision by the Commissioner of the Social Security Administration, which denied 
the Plaintiff’s applications for disability insurance benefits (“DIB”) and supplemental 
security  income (“SSI”).  In  Plaintiff’s  Motion  for  Summary  Judgment  (Dkt.  No.  9), 
Plaintiff  argues  that  the  administrative  law  judge  (“ALJ”)  who  authored  the  written 
decision erred in evaluating the severity of Plaintiff’s mental health impairments and in 
assessing Plaintiff’s residual functional capacity (“RFC”). In Defendant’s responsive Brief 
(Dkt. No. 17), Defendant asserts that the ALJ did not err in either respect and asks the 
Court to affirm the final decision. As set forth below, the Court agrees with Defendant and 
concludes that the ALJ did not err. The Court therefore denies Plaintiff’s Motion for 
Summary  Judgment  and  grants  the  relief  requested  in  Defendant’s  Brief.  The 
Commissioner’s final decision is affirmed.                                
I.   Background                                                           
   Plaintiff was 32 years old on the date of the Commissioner’s final decision. (See R. 
35, 36.)1 He has an 11th grade education and past relevant work as a housekeeper, laborer, 

packager, painter, and translator. (R. 538–39.) Plaintiff contends he has been disabled since 
March 30, 2017, due to a somatization disorder, depression, back pain, and shoulder pain. 
(R. 537, 588.)                                                            
   A.   Relevant Evidence                                               
   To be entitled to DIB, Plaintiff must show he was disabled before his insured status 

expired on June 30, 2020. (R. 15); Moore v. Astrue, 

 (8th Cir. 2009). The 
relevant period for DIB purposes is from January 1, 2017, the alleged onset-of-disability 
date, through June 30, 2020, the date Plaintiff was last insured. See Moore, 

. To be entitled to SSI, Plaintiff must show he was disabled between the date he filed 
his application, see Cruse v. Bowen, 

 (8th Cir. 1989) and the date of 

the ALJ’s decision, see Myers v. Colvin, 

 (8th Cir. 2013) (using the date 
of the ALJ’s decision on the SSI claim to mark the end of the relevant time period). Thus, 
the relevant period for SSI benefits is September 30, 2019, the date Plaintiff filed his SSI 
application (R. 115), through March 31, 2022, the date of the ALJ’s decision (R. 36). The 
Court limits its summation of evidence to the evidence relevant to these time periods and 

to the issues presented for judicial review.                              


1 The administrative record is filed at Dkt. No. 7. The record is consecutively paginated, 
and the Court cites to that pagination rather than ECF number and page.   
   Plaintiff attended an appointment with Dr. Esayas Okubamichael on September 28, 
2017, for treatment of shoulder and back pain, loss of interest, and fatigue. (R. 787.) The 

doctor described Plaintiff’s psychiatric symptoms as “chronic fatigue and loss of interest. 
Feels depressed.” (R. 788.) Plaintiff’s PHQ-9 score was 20.2 (R. 789.) Dr. Okubamichael’s 
objective psychiatric findings were “[w]ell-oriented, normal speech, normal cognition and 
insight,  slightly  depressed  mood.”  (R.  788.)  Dr.  Okubamichael  referred  Plaintiff  for 
behavioral health treatment. (R. 789.)                                    
   On October 31, 2017, Plaintiff consulted with Dr. Ryan Engdahl about his pain and 

depression.  Dr. Engdahl recorded a PHQ-9 score of 20. (R.  657.) The mental status 
examination was unremarkable. (R. 658.) In particular, Plaintiff was not anxious but was 
alert and oriented, and he had a full range of affect, a euthymic mood, logical thought 
processes and content, good insight and judgment, appropriate tolerance to frustration, and 
a good memory. (R. 658–59.) Dr. Engdahl recommended that Plaintiff follow up with his 

prescribing doctor to identify the most effective medications, attend physical therapy for 
his physical issues, and meet again with Dr. Engdahl to address his mood and stress 
management. (R. 657.)                                                     
   Plaintiff returned to Dr. Engdahl on January 2, 2018. Plaintiff denied having mental 
health issues but said his back pain was stressful. (R. 660.) Dr. Engdahl reported findings 

similar to the mental status examination in October 2017. (R. 661.) Plaintiff’s PHQ score 

2  “PHQ”  is  an  acronym  for  Patient  Health  Questionnaire.  PHQ-9  questionnaires  are 
completed independently by a patient and are intended to reflect subjective, self-reported 
symptoms. See Amy R. v. Saul, No. 19-CV-1508 (KMM), 

, at *1 (D. 
Minn. June 10, 2020).                                                     
was 13, indicating moderate depression. (R. 25, 663.) In March 2018, Plaintiff told Dr. 
Engdahl that back pain was his main stressor and described his current pain as a “1.5.” (R. 

662.) He told Dr. Engdahl he was not interested in pursuing physical therapy. His PHQ 
score was 6, indicating mild depression. (R. 25, 663.)                    
   Plaintiff attended an appointment with Dr. Adei Shaqra on June 7, 2019. He said his 
pain was “half a percent” and that one Tylenol taken in the morning lasted all day. (R. 723.) 
The physical examination was unremarkable, although Dr. Shaqra noted that Plaintiff’s 
affect was flat and the doctor was not sure how much Plaintiff understood him. (R. 724.) 

Dr. Shaqra thought Plaintiff “may benefit from a functional capacity assessment” and 
would “certainly need a neuropsych evaluation” for cognitive functioning. (R. 725.)  
   In 2020, four state agency psychological consultants (Drs. Bonnie Katz, Rohini 
Mendonca, Jeffrey Boyd, and Gregory H. Salmi) each reviewed the Plaintiff’s medical 
records and other relevant evidence. They each opined that Plaintiff was moderately limited 

in each of the four broad areas of mental functioning: (1) understanding, remembering, and 
applying information; (2) concentrating, persisting, and maintaining pace; (3) interacting 
socially; and (4) adapting or managing himself. (R. 121, 136, 156, 171.)  
   An unsigned “Behavioral Health Psychological Assessment” reflecting assessments 
in February and April 2021 is part of the record. (R. 1025–33.) The assessor’s mental status 

examination findings included good cooperation, normal speech, good mood, a restricted 
and flat affect, logical thoughts, no anxious disturbances, good alertness and orientation, 
difficulties with short-term and long-term memory, and average judgment and insight. (R. 
1029.)  The  examiner  diagnosed  Plaintiff,  in  relevant  part,  with  a  mild  cognitive 
impairment, a major depressive disorder that was recurrent but in partial remission, and an 
unspecified anxiety disorder. (R. 1032.) The examiner also administered several tests, on 

which Plaintiff performed within the less-than-one-percentile group across all cognitive 
domains. (R. 1031.)                                                       
   In  March  2021,  the  ALJ  asked  the  Cooperative  Disability  Investigations  Unit 
(“CDIU”) of the Social Security Administration’s Office of the Inspector General to 
investigate whether Plaintiff was malingering. (R. 618.) While conducting surveillance, an 
investigator observed Plaintiff and another person walk more than 1.5 miles in 90-degree 

heat to a residence, then back to Plaintiff’s residence, stopping along the way at a gas 
station and liquor store. (R. 624.) At that time, Plaintiff was living in a residential boarding 
facility for individuals who needed psychiatric care, were chemically dependent, or needed 
transitional housing. (R. 625.) The resident nurse told the investigator that Plaintiff did not 
fit any of those criteria. The nurse also said that Plaintiff “required minimal care and was 

very independent and capable of performing all of his daily needs.” (R. 626.)  
   B.   Procedural History                                              
   Plaintiff’s DIB and SSI applications were denied at both the initial review and 
reconsideration stages. He requested an administrative hearing before an ALJ, and that 
hearing took place on November 12, 2020. (See R. 12.) The hearing was continued to retain 

a medical expert and to allow Plaintiff to undergo a neuropsychological evaluation. (See 
R. 12.) A supplemental hearing occurred on May 26, 2021. (See R. 12.) An impartial 
medical expert, Dr. Michael Carney, appeared and testified, but that hearing was continued 
so that Dr. Carney could review newly submitted evidence. (See R. 12.) Dr. Carney is a 
licensed clinical psychologist. (R. 68.) A third hearing was convened on November 2, 
2021. (See R. 12.) Dr. Carney again appeared and testified, as did Sheila Capizzi, a 

vocational expert. (See R. 12–13.) The ALJ held the hearing open for 14 days to receive 
new evidence, and both the CDIU report and a Professional Statement of Need form (R. 
1196–1200) were received. A fourth hearing was held on March 17, 2022. (See R. 13.)  
   Relevant to the issues presented for judicial review, at the November 2021 hearing 
Dr. Carney considered whether Plaintiff’s impairments met or equaled the “listings” for a 
somatic symptom disorder, depressive disorder, or neurodevelopmental disorder.3 (R. 69–

70.) The doctor testified that Plaintiff’s case was “very problematic” in making that 
determination because “he certainly claims he’s got these ongoing pains but . . . they could 
find no organic basis, no [etiology] for these pains and yet nonetheless he reports them and 
certainly they think that they are disabling.” (R. 70.) Dr. Carney further testified that no 
physical findings supported Plaintiff’s claim of inability to work. (R. 70.) Dr. Carney 

pointed out that the neuropsychological examination results (that Plaintiff was in the less-
than-one-percentile group for every test) were either based on Plaintiff’s subjective reports 
or were not consistent with mild scores and normal mental status examinations documented 
throughout his medical records. (R. 70–71.) In particular, no provider had found that 
Plaintiff was slow, had borderline intellectual functioning, or had an intellectual disability. 


3 The “listings,” also known as the Listing of Impairments, set the criteria the SSA uses in 
determining whether a particular impairment “is severe enough to prevent an individual 
from doing any gainful activity, regardless of his or her age, education, or work experience” 
or, put simply, makes the claimant disabled. 

(a), 404.1520(a)(4)(iii), 
416.925(a), 416.920(a)(4)(iii); see generally 20 C.F.R. pt. 404, subpt. P, app. 1. 
(R. 71.) Nor were the neuropsychological examination results consistent with Plaintiff’s 
ability to work in the past, even though that work was unskilled. (R. 72–73.) If the scores 

were accurate, Dr. Carney testified, Plaintiff would be “nonfunctional basically.” (R. 73.)  
   On March 31, 2022, the ALJ issued a written decision finding Plaintiff not disabled. 
(R. 12–36.) The ALJ followed the familiar five-step sequential analysis outlined in 

 and 416.920. At each step, the ALJ considered whether Plaintiff was 
disabled based on the criteria of that step. If he was not, the ALJ proceeded to the next step. 
See 

(a)(4), 416.920(a)(4).                           

   The ALJ first determined that Plaintiff had not engaged in substantial gainful 
activity since the alleged onset date. (R. 15.) At the second step of the sequential analysis, 
the ALJ found that Plaintiff had the following severe impairments: somatic symptom 
disorder,  major  depressive  disorder,  cannabis  use  disorder,  and  neurodevelopmental 
disorder. (R. 15.)                                                        

   At step three, the ALJ concluded that Plaintiff’s impairments did not meet or 
medically equal the severity of an impairment listed in 20 C.F.R. part 404, subpart P, 
appendix I. (R. 17.) The ALJ considered listings for neurocognitive disorders (Listing 
12.02); depressive, bipolar, and related disorders (Listing 12.04); somatic symptom and 
related  disorders  (Listing  12.07);  and  trauma-  and  stressor-related  disorders  (Listing 

12.15). (R. 17.) None of the listings were met or medically equaled because Plaintiff was 
only “moderately” limited in his abilities to understand, remember, or apply information; 
to interact with others; to concentrate, persist, or maintain pace; and to adapt or manage 
himself.4 (R. 17–19.)                                                     

   Before  proceeding  to  step  four,  the  ALJ  assessed  Plaintiff’s  RFC,  which  is  a 
measure  of  “the  most  [he]  can  still  do  despite  [his]  limitations.”  

(a)(1), 416.945(a)(1). The ALJ’s RFC assessment included consideration of 
the  medical  opinion  evidence.  The  ALJ  found  Dr.  Carney’s  opinion  persuasive,  the 
opinions  of  the  state  agency  psychological  consultants  partially  persuasive,  and  the 
neuropsychological examination findings not persuasive. (R. 33–34.) Ultimately, the ALJ 

found that Plaintiff                                                      
   has the residual functional capacity to perform a full range of work at all 
   exertional  levels  but  with  the  following  nonexertional  limitations:  The 
   claimant is limited to simple routine repetitive tasks and may have occasional 
   superficial contact with others where superficial is rated no lower than an 8 
   on the Selected Characteristics of Occupations’ people rating.       

(R. 21.) With this RFC, the ALJ concluded, Plaintiff could perform his past work as a 
housekeeper or packager. (R. 34.) Consequently, Plaintiff was not disabled. (R. 36.)  
   The Appeals Council denied Plaintiff’s request for review of the ALJ’s decision. 
(R. 1.) This made the ALJ’s decision the final decision of the Commissioner for the purpose 
of judicial review.                                                       



4 To meet or medically equal one of these listings under the criteria applied by the ALJ (the 
“paragraph B” criteria), Plaintiff’s impairments must have caused one “extreme” limitation 
or two “marked” limitations. 20 C.F.R. pt. 404, subpt. P, app. 1.         
II.  Standard of Review                                                   
   Judicial review of the Commissioner’s denial of benefits is limited to determining 

whether substantial evidence in the record as a whole supports the decision, 

(g), or whether the ALJ committed an error of law, Nash v. Commissioner, Social 
Security Administration, 

 (8th Cir. 2018). “Substantial evidence is less 
than a preponderance but is enough that a reasonable mind would find it adequate to 
support the Commissioner’s conclusion.” Krogmeier v. Barnhart, 

 
(8th Cir. 2002) (citing Prosch v. Apfel, 

 (8th Cir. 2000)). The Court 

must  examine  “evidence  that  detracts  from  the  Commissioner’s  decision  as  well  as 
evidence that supports it.” 

 (citing Craig v. Apfel, 

 (8th Cir. 2000)). 
The Court may not reverse the ALJ’s decision simply because substantial evidence would 
support a different outcome or because the Court would have decided the case differently. 

 (citing Woolf v. Shalala, 

 (8th Cir. 1993)). In other words, if it is 

possible to reach two inconsistent positions from the evidence and one of those positions 
is that of the Commissioner, the Court must affirm the decision. Robinson v. Sullivan, 

 (8th Cir. 1992).                                            
   A claimant has the burden to prove disability. See Roth v. Shalala, 

 
(8th Cir. 1995). To meet the definition of disability for DIB and SSI, the claimant must 

establish that he is unable “to engage in any substantial gainful activity by reason of any 
medically determinable physical or mental impairment which can be expected to result in 
death or which has lasted or can be expected to last for a continuous period of not less than 
12  months.”  

(d)(1)(A),  1382c(a)(3)(A).  The  disability,  not  just  the 
impairment, must have lasted or be expected to last for at least twelve months. Titus v. 
Sullivan, 

 (8th Cir. 1993).                                

III.  Discussion                                                          
   Plaintiff raises several points of error in support of his arguments that the ALJ erred 
in  evaluating  the  severity  of  Plaintiff’s  mental  health  impairments  and  in  assessing 
Plaintiff’s RFC. The Court addresses each in turn below.                  
   A.   Substantial  evidence  supports  the  ALJ’s  finding  that  Plaintiff  had 
        relatively few symptom reports and unremarkable or normal mental 
        status examination findings.                                    

   Plaintiff first takes issue with the ALJ’s finding that Plaintiff had relatively few 
symptom reports and unremarkable or normal mental status findings. (Pl.’s Mem. at 3.) 
Plaintiff identifies several pages in the record that contain evidence contrary to the ALJ’s 
finding. For example, Plaintiff cites to an exhibit documenting a PHQ-9 score of 20 and 
points out that such a score indicates “severe depression.” (Pl.’s Mem. at 3 (citing R. 657).) 
Indeed, the ALJ acknowledged the PHQ-9 score of 20, but the ALJ also noted several other 
PHQ-9 scores in the range between 6 and 13, which indicated only mild to moderate 
depression. (R. 25, 29–30.) In determining that Plaintiff’s PHQ-9 scores, on balance, 
indicated  no  more  than  mild  depression,  the  ALJ  referred  to  treatment  notes  that 
documented relatively normal or insignificant mental status examination findings and 

progress notes that reflected Plaintiff’s belief that he could not work if he had any amount 
of pain. (R. 29–30.)                                                      
   Other evidence, specifically mentioned by the ALJ in his written decision, also 
supports  the  ALJ’s  finding  that  Plaintiff  had  relatively  few  symptom  reports  and 
unremarkable or inconsistent mental status examination findings. Significantly, Plaintiff’s 
providers could not find a cause for his pain, nor did physical findings support an inability 

to work. (R. 22.) Plaintiff indicated more than once that he needed to be pain-free in order 
to  work.  (R.  24–25,  27.)  Plaintiff  attributed  his  mental  impairments  to  pain,  yet  he 
described his pain as minimal: either less than one percent or a “1.5.” (R. 25–26.) Mental 
status  examinations  findings  were  frequently  normal,  including  intact  memory,  good 
memory recall, normal cognition, and good attention and concentration. (R. 24–27; see, 
e.g., 658–59, 661, 664–65, 668–69, 673, 677, 681–82, 685–86, 691–92, 696, 809, 816, 

844–45, 870, 937.) In identifying evidence to the contrary, Plaintiff essentially asks this 
Court to reweigh the evidence, which the Court may not do. Naber v. Shalala, 

 (8th Cir. 1994) (“We do not reweigh the evidence or review the factual record de 
novo.”).                                                                  
   It is clear from the ALJ’s decision that he was aware of the inconsistencies and 

conflicting statements in the record concerning Plaintiff’s symptoms and mental state. It 
was the ALJ’s duty to resolve those conflicts. Richardson v. Perales, 

 
(1971). Substantial evidence supports the ALJ’s finding that Plaintiff had relatively few 
symptom reports and unremarkable or inconsistent mental status examination findings. 
   B.   The  ALJ  did  not  disregard  evidence  from  Drs.  Shaqra  and 
        Okubamichael.                                                   

   Relatedly, Plaintiff contends that the ALJ disregarded certain evidence from Drs. 
Shaqra and Okubamichael. (Pl.’s Mem. at 4.) In particular, Plaintiff notes that Dr. Shaqra 
wrote that Plaintiff might need a functional capacity assessment and a neuropsychological 
evaluation, and that Plaintiff had a flat affect and may not have understood Dr. Shaqra. The 
ALJ did not overlook this evidence. Rather, the ALJ specifically noted Dr. Shaqra’s finding 

of a flat affect but also cited other findings of a full or normal affect. (R. 24–27.) The ALJ 
also considered Dr. Shaqra’s comment that he was not sure how much of their conversation 
Plaintiff understood. (R. 26.) With respect to Dr. Shaqra’s belief that Plaintiff might need 
a functional capacity assessment and a neuropsychological evaluation, the ALJ recessed 
Plaintiff’s  first  hearing  to  obtain  a  neuropsychological  report,  and  the  state  agency 
consultants conducted both physical and mental functional capacity assessments. (R. 122–

27, 158–62.) Not only did the ALJ consider the evidence from Dr. Shaqra at issue, but 
Plaintiff has not explained how the evidence would have required the ALJ to reach a 
different result. See Fentress v. Berryhill, 

 (8th Cir. 2017). 
   Similarly, Plaintiff contends that the ALJ disregarded Dr. Okubamichael’s findings 
that Plaintiff had chronic fatigue, loss of interest, and feelings of depression. (Pl.’s Mem. 

at 4.) To the contrary, the ALJ referred to this medical record in the written decision; noted 
Plaintiff’s self-reports of back pain, fatigue, and loss of interest; and acknowledged a 
mental status examination finding of a slightly depressed mood. (R. 24 (citing R. 787–88).) 
As with Dr. Shaqra, Plaintiff has not explained how this evidence from Dr. Okubamichael  
would have required a different outcome.                                  

   C.   The ALJ did not err by relying on evidence from nonacceptable medical 
        sources.                                                        

   Plaintiff next faults the ALJ for relying on evidence from Elizabeth Perdue, a 
registered  nurse,  and  Colette  Neron  Ellenbecker,  a  licensed  social  worker,  without 
acknowledging that these individuals were not “acceptable medical sources.”5 (Pl.’s Mem. 
at 5, 6.) Ms. Perdue periodically checked-in with Plaintiff concerning his care. (E.g., R. 

929.) In February 2022, Ms. Ellenbecker conducted an annual diagnostic assessment of 
Plaintiff’s mental status and level of functioning to ascertain his need and eligibility for 
Adult Rehabilitative Mental Health Services (“ARMHS”). (R. 1162–70.) Plaintiff further 
contends the ALJ should not have relied on evidence from Rachel Geier, a licensed social 
worker, even though the ALJ acknowledged she was not an acceptable medical source. Ms. 
Geier consulted with Plaintiff for treatment of depression and stress. (E.g., R. 713.)  

   The ALJ did not err by relying on evidence from Ms. Perdue, Ms. Ellenbecker, and 
Ms. Geier. Although only an acceptable medical source can provide objective medical 
evidence to establish a physical or mental impairment, see 

, the ALJ 
may consider statements from other medical sources and from nonmedical sources in 
assessing a claimant’s RFC, see 

(a)(3), (e). The ALJ may also 

consider statements from “nonacceptable” medical sources and nonmedical sources in 
evaluating symptoms such as pain. 

(a), 416.929(a).   
   Plaintiff also points out that the ALJ did not acknowledge notations from Ms. 
Perdue such as “confused,” “loose association,” and “unable to assess.” (Pl.’s Mem. at 5.) 
Plaintiff has not shown, however, how this evidence would have required the ALJ to reach 




5 An “acceptable medical source” includes licensed physicians, licensed psychologists, 
licensed advanced practice registered nurses, and licensed physician assistants, among 
others. 

(a), 416.902(a).                             
a different result. In addition, an ALJ need not discuss each notation in every treatment 
record.                                                                   

   D.   The ALJ did not find that Plaintiff had no mental impairments.  

   Plaintiff asks in his memorandum, perhaps rhetorically, “if he didn’t have mental 
health issues, why wasn’t he discharged?” (Pl.’s Mem. at 7.) The ALJ did not determine, 
however, that Plaintiff had no mental health issues or impairments. To the contrary, the 
ALJ determined that Plaintiff had a somatic symptom disorder, major depressive disorder, 
and neurodevelopmental disorder, and that these disorders were severe impairments. (R. 
15.) The ALJ also found that, as a result of these impairments, Plaintiff should be limited 
to simple, routine, and repetitive tasks and to only occasional and superficial contact with 
others. (R. 21.) The ALJ did not suggest that Plaintiff had no mental impairments or should 
cease treatment.                                                          
   E.   The ALJ did not disregard evidence from Drs. Gamaliel Ferrer and 
        Michael Balfanz.                                                

   Plaintiff refers to treatment records from Drs. Gamaliel Ferrer and Michael Balfanz, 
who treated Plaintiff for physical conditions, that also mention Plaintiff’s mental health 
and intellectual abilities. (Pl.’s Mem. at 7.) In February 2021, Dr. Ferrer completed a 
Minnesota  Department  of  Human  Services  Professional  Statement  of  Need  form  for 
Plaintiff to receive housing support and stabilization services. (R. 1112–13.) Dr. Ferrer 
checked  the  box  “mental  health”  for  the  required  “disabling condition”  and  the  box 
indicating that the condition would last at least one year. The form explained that a 

disability determination or formal diagnostic assessment was not required, and Dr. Ferrer 
provided no other information about the “disabling condition.” In June 2019, Dr. Balfanz, 
a chiropractor, remarked that Plaintiff was “having a bit of difficulty communicating with 

me due to language as well as intellectual ability.” (R. 702.)            
   Plaintiff has not explained how this evidence would have required the ALJ to reach 
a different result. The form completed by Dr. Ferrer is conclusory and lacks any supporting 
findings or details. Dr. Balfanz’s remark appears to be an isolated one; lacks supporting 
findings or details; and is inconsistent with numerous other treatment records cited by the 
ALJ in the decision, documenting Plaintiff’s ability to communicate effectively (R. 18, 24, 

25, 27, 31, 34). In addition, an ALJ is not required to discuss each and every treatment note 
in the record, and these conclusory records are of tangential relevance to Plaintiff’s mental 
impairments. Finally, to the extent these records could be considered substantial evidence, 
simply because they could support a different outcome does not mean the ALJ’s decision 
is not supported by substantial evidence.                                 

   F.   The ALJ properly considered the CDIU report.                    

   Plaintiff asserts that the CDIU report did not really address his mental health 
impairments and thus the ALJ should not have considered it. (Pl.’s Mem. at 9.) The ALJ 
referred  Plaintiff’s  case  to  the  CDIU  to  resolve  conflicting  evidence  in  the  record 
concerning  Plaintiff’s  pain.  The  ALJ  recounted  several  of  the  investigative  findings 
including Plaintiff’s ability to walk for extended periods of time, ability to spend time with 
others, and ability to function essentially independently at his residential boarding facility. 
(R. 30–31.) The CDIU report was directly relevant to whether Plaintiff could function 
better than he claimed. The report supports the ALJ’s RFC findings that Plaintiff could 
work at all exertional levels; with limitations to simple, routine, and repetitive tasks; and 
with occasional and superficial contacts with others. The CDIU report also supports the 

ALJ’s  determination  that  Plaintiff’s  statements  about  the  intensity,  persistence,  and 
limiting effects of his symptoms—including pain—were not consistent with the medical 
and other evidence of record. And, finally, the CDIU report is inconsistent with the 
neuropsychological examination results, which, if believed, indicated that Plaintiff was 
basically nonfunctional.                                                  
   Plaintiff  also  argues  that  the  resident  nurse  had  indicated  on  a  Professional 

Statement of Need form in March 2020 that Plaintiff had a “mental illness” and would need 
assistance for a year or more, which is inconsistent with her comments to the investigator 
in March 2021 as reflected in the CDIU report. The Professional Statement of Need form 
is conclusory, however, and lacks any supporting findings or details. (R. 1110–11.) The 
nurse simply checked the box for “mental illness” and other boxes, without providing any 

explanation, documentation, or findings. Moreover, as with the form completed by Dr. 
Ferrer, Plaintiff has not explained how the March 2020 form would have required the ALJ 
to reach a different result. The form is inconsistent with other evidence of record, including 
the nurse’s statements to the investigator, and it is the ALJ’s duty to resolve inconsistencies 
in the record. See Perales, 

. Finally, to the extent the form could be 

considered  substantial  evidence,  it  does  not  overcome  the  substantial  evidence  that 
supports the ALJ’s decision.                                              
   G.   The ALJ properly resolved inconsistencies about Plaintiff’s functioning. 

   Plaintiff argues that the ALJ’s finding about Plaintiff’s ability to complete tasks is 
inconsistent with a Function Report that Plaintiff filled out. (Pl.’s Mem. at 9.) The ALJ 
found  that  Plaintiff  “reported  difficulty  with  concentration,  but  did  not  indicate  any 
difficulty completing tasks.” (R. 18–19.) Plaintiff concedes that he did not check the box 
on the Function Report that indicated problems completing tasks. (R. 569.) Plaintiff points 
out, however, that he answered “No” to the question, “Do you finish what you start?” (R. 
569.)                                                                     

   It was the ALJ’s duty to resolve inconsistencies in the evidence. See Perales, 

. To the extent Plaintiff’s responses were inconsistent, the ALJ did not err by 
finding  that  Plaintiff  did  not  have  problems  completing  tasks.  Substantial  evidence 
supports this finding, not the least of which are Plaintiff’s own responses on the Function 
Report. Other substantial evidence, cited by the ALJ in the written decision, includes 

Plaintiff’s  abilities  to  prepare  simple  meals,  do  his  own  laundry,  and  use  public 
transportation; numerous mental status examination findings of no significant issues with 
concentration; and the opinions of state agency psychological consultants who found that 
Plaintiff could perform concrete, simple, short-cycle tasks. (R. 18–19, 32.) In addition, the 
ALJ found that Plaintiff’s statements about the intensity, persistence, and limiting effects 

of his symptoms were not consistent with the objective medical evidence. (R. 22.) This 
would include Plaintiff’s statement that he cannot finish what he starts. Finally, the ALJ 
did not conclude that Plaintiff had no limitation in his ability to complete tasks. Rather, the 
ALJ concluded that Plaintiff’s ability to concentrate, persist, and maintain pace, which 
would include his ability to complete tasks, was moderately limited. The ALJ therefore 
limited Plaintiff to simple, routine, repetitive tasks in the RFC assessment. The Court 

concludes that the ALJ did not err in resolving inconsistencies about Plaintiff’s functioning.  
   H.   The ALJ did not fail in his duty to fully and fairly develop the record.  

   Plaintiff submits that the ALJ erred in his duty to fully and fairly develop the record. 
Specifically,  Plaintiff  contends  that  the  ALJ  should  have  ordered  a  post-hearing 
neuropsychological evaluation by a consultative examiner to address Dr. Carney’s concern 
with the lack of physical findings to support Plaintiff’s claims of pain and inability to work 
and  to  address  the  ALJ’s  skepticism  about  the  accuracy  of  the  neuropsychological 
evaluation findings. (Pl.’s Mem. at 10–11.)                               
   The Court finds that the ALJ did not err. The ALJ’s duty to fully and fairly develop 
the record is not limitless. “An ALJ is required to obtain additional medical evidence if the 
existing medical evidence is not a sufficient basis for a decision.” Naber v. Shalala, 

 (8th Cir. 1994) (citation omitted). On the other side of the coin, “an ALJ is 
permitted to issue a decision without obtaining additional medical evidence so long as other 
evidence in the record provides a sufficient basis for the ALJ’s decision.” 

 (citation 
omitted).                                                                 
   Here, the existing medical record provided a sufficient basis for the ALJ’s decision. 

Before the first hearing, the record already contained numerous treatment records and 
progress notes, medical source opinions, a function report from Plaintiff, and evidence 
from  non-medical  sources.  The  ALJ  postponed  three  hearings  to  receive  additional 
evidence.  During  those  postponements,  the  ALJ  allowed  Plaintiff  to  submit  a 
neuropsychological report, arranged for testimony from a medical expert, and gave the 
medical expert time to review new evidence. After the fourth hearing, the ALJ held open 

the record and received the CDIU report and a Professional Statement of Need form.  
   With particular respect to Dr. Carney’s concern with the lack of physical findings 
that would support Plaintiff’s claims of pain and inability to work, the ALJ effectively 
resolved that concern by finding Plaintiff’s statements about his pain and ability to work 
inconsistent with the objective medical evidence. The ALJ recounted evidence of normal 
or unremarkable physical and mental status examinations, Plaintiff’s belief that he would 

need to be pain-free in order to work, Plaintiff’s lack of follow-through with physical 
therapy, and the CDIU report that contained no observations of pain or other difficulties, 
among other evidence. (R. 24–31.) The ALJ explicitly found Plaintiff’s “exam findings 
and providers’ objective observations do not support the level of alleged limitations.” (R. 
22.) It is not likely that another neuropsychological evaluation would have provided the 

lacking physical findings.                                                
   The ALJ resolved his own skepticism about the accuracy of the neuropsychological 
evaluation by finding the report not persuasive. (R. 33.) The ALJ noted that the report was 
in direct contrast with normal mental status examinations, “all other treating providers’ 
objective observations,” Plaintiff’s ability to work in the past, and the CDIU report. (R. 

33–34.) If the findings in the neuropsychological evaluation were accepted, Plaintiff would 
be essentially non-functional, and that lack of functioning was starkly inconsistent with 
nearly all of the evidence of record.                                     
   In sum, the Court concludes the ALJ met his duty to fully and fairly develop the 
record.                                                                   

   I.   The ALJ did not err by relying on Dr. Carney’s testimony.       
   Plaintiff argues that the ALJ should not have relied on Dr. Carney’s testimony 
because Dr. Carney “waxed and waned” on Plaintiff’s ability to maintain concentration, 
pace, and persistence. (Pl.’s Mem. at 12.) It is the ALJ’s role to assess a claimant’s RFC. 
See 

, 416.946. Based on the ALJ’s consideration of the evidence, he 
determined that Plaintiff had no more than moderate limitations in his ability to maintain 

concentration, pace, and persistence. The ALJ noted that Dr. Carney “deferred to opine as 
to limitations in concentrating, persisting, or maintaining pace,” but the ALJ then supported 
the moderate limitation in this area with medical evidence from Plaintiff’s providers and 
the opinions of the state agency psychological consultants.               
   Plaintiff also submits that Dr. Carney “struggled to understand the level of support” 

that he had at his residential boarding facility. (Pl.’s Mem. at 11.) The support Plaintiff 
received, however, is beside the point. The relevant inquiry is what activities Plaintiff could 
perform, and there is ample evidence that Plaintiff could care for himself, make simple 
meals, do his own laundry, shop for himself, walk for extended periods of time without 
visible pain or difficulty, socialize with others, use public transportation, and make his own 

medical appointments. The nurse at the facility said that Plaintiff required minimal care 
and was very independent.                                                 
   Plaintiff next suggests that Dr. Carney should not have relied on the Function Report 
because the form was completed by an individual named Billy Anderson and there is no 
proof that the answers came from Plaintiff. (Pl.’s Mem. at 11–12.) Plaintiff was not 
troubled by Billy Anderson’s involvement, however, when he asked the Court to take into 

account the answer “No” to the question, “Do you finish what you start?” on the Function 
Report. Moreover, Plaintiff neglects to mention that Billy Anderson was his non-attorney 
representative at that time. (See R. 209.) The Court finds this argument unconvincing.  
   J.   The  ALJ  properly  considered  the  neuropsychological  examination 
        report.                                                         

   Plaintiff  takes  issue  with  the  ALJ’s  failure  to  incorporate  the  results  of  the 
neuropsychological examination into the RFC and hypothetical question posed to the 
vocational  expert.  (Pl.’s  Mem.  at  15.)  The  Court  has  already  touched  on  the  ALJ’s 
determination  that  the  neuropsychological  evaluation  report  was  not  persuasive,  but 
expands that discussion here.                                             
   Title 

.1520c and 416.920c set forth the standards under which an 
ALJ considers medical opinion evidence. An ALJ considers how “persuasive” an opinion 
is according to five factors: supportability, consistency, relationship with the claimant, 
specialization,  and  any  other  relevant  factors.  

.1520c(c)(1)–(5), 

416.920c(c)(1)–(5). The “most important factors” are supportability and consistency. 

.1520c(b)(2), 416.920c(b)(2). The ALJ “may, but [is] not required to,” 
explain  how  the  remaining  factors  were  considered.  

.1520c(b)(2), 
416.920c(b)(2). The regulatory language pertaining to supportability provides that “[t]he 
more relevant the objective medical evidence and supporting explanations presented by a 

medical source are to support his or her medical opinion(s) or prior administrative medical 
finding(s),  the  more  persuasive  the medical  opinions  or  prior  administrative medical 
finding(s)  will  be.”  

.1520c(c)(1),  416.920c(c)(1).  In  evaluating 

consistency, “[t]he more consistent a medical opinion(s) or prior administrative medical 
finding(s) is with the evidence from other medical sources and nonmedical sources in the 
claim, the more persuasive the medical opinions or prior administrative medical finding(s) 
will be.” 

.1520c(c)(2), 416.920c(c)(2). In other words, supportability 
looks to how well the medical source justifies their own opinion, and consistency looks to 
how well the medical source’s opinion fits with evidence from other sources.  

   The Court finds that the ALJ adequately considered the persuasiveness of the 
neuropsychological examination report and did not err in deeming it not persuasive. The 
ALJ exhaustively detailed how the findings in the report were inconsistent with evidence 
from other medical and nonmedical sources, including mental status examination findings, 
the CDIU report, treating providers’ objective observations, frequently mild PHQ-9 scores, 

and Plaintiff’s ability to work in the past. (R. 33–34.)                  
   The ALJ also found the report was not supported by the examiner’s own mental 
status  examination  findings,  which  noted  that  Plaintiff  was  dressed  and  groomed 
appropriately, walked with a normal and independent gait, had good eye contact, was 
cooperative, spoke normally, had no movement abnormalities, appeared to be in a good 

mood, had logical thought processes and content, displayed no loosening associations, 
showed  no  anxious  disturbances,  was  alert  and  fully  oriented,  had  developmentally 
appropriate attention and concentration, could describe recent events, showed an average 
fund of knowledge, used developmentally appropriate language, and had average insight 
and judgment. (R. 33.) Nor was the report supported by evidence of an intervening head 
trauma or other significant event that would explain such a grave degree of cognitive 

decline. (R. 34.)                                                         
IV.  Conclusion                                                           
   The Commissioner’s final decision is supported by substantial evidence in the 
record as a whole, and the ALJ committed no error of law. Accordingly, IT IS HEREBY 
ORDERED THAT:                                                             
1.  Plaintiff’s Motion for Summary Judgment (Dkt. No. 9) is DENIED.     

2.  The relief requested in Defendant’s Brief (Dkt No. 17) is GRANTED, and the 
   Commissioner’s final decision is AFFIRMED.                           

LET JUDGMENT BE ENTERED ACCORDINGLY.                                      


Date: June 17, 2024             s/  John F. Docherty                    
                                JOHN F. DOCHERTY                        
                                United States Magistrate Judge