IN THE UNITED STATES DISTRICT COURT FOR THE MIDDLE DISTRICT OF NORTH CAROLINA

KIMBERLY FREEZE, ) ) Plaintiff, ) ) v. ) 1:21CV275 ) KILOLO KIJAKAZI, ) Acting Commissioner of Social Security,! ) ) Defendant. )

MEMORANDUM OPINION AND RECOMMENDATION OF UNITED STATES MAGISTRATE JUDGE Plaintiff Kimberly Freeze (“Plaintiff”) brought this action pursuant to Sections 205(g) and 1631(c)(3) of the Social Security Act (the “Act”), as amended (

(g) and 1383(c)(3)), to obtain judicial review of a final decision of the Commissioner of Social Security denying her claims for Disability Insurance Benefits and Supplemental Security Income under, respectively, Titles II and XVI of the Act. The parties have filed cross-motions for judgment, and the administrative record has been certified to the Court for review. I. PROCEDURAL HISTORY Plaintiff protectively filed applications for Disability Insurance Benefits and Supplemental Security Income Benefits on February 20, 2019 and February 5, 2019, respectively, alleging a disability onset date of July 25, 2018 in both applications. (I'r. at 17,

1 Kilolo Kijakazi was appointed as the Acting Commissioner of Social Security on July 9, 2021. Pursuant to Rule 25(d) of the Federal Rules of Civil Procedure, Kilolo Kijakazi should be substituted for Andrew M. Saul as the Defendant in this suit. Neither the Court nor the parties need take any further action to continue this suit by reason of the last sentence of section 205(g) of the Social Security Act,

(g).

301-09.) Her applications were denied initially (Tr. at 94-125, 206-10) and upon reconsideration (T'r. at 126-205, 217-30). Thereafter, Plaintiff requested an administrative hearing de novo before an Administrative Law Judge (“ALJ”). (Tr. at 235-36.) Plaintiff, along with her attorney and an impartial vocational expert, attended the subsequent telephonic heating on April 27, 2020. (Ir. at 17.) The AL] ultimately concluded that Plaintiff was not disabled within the meaning of the Act (Ir. at 27), and, on February 4, 2021, the Appeals Council denied Plaintiffs request for review of the decision, thereby making the AL]’s conclusion the Commissionet’s final decision for purposes of judicial review. (I'r. at 1-6.) II. LEGAL STANDARD Federal law “authorizes judicial review of the Social Security Commissionet’s denial of social secutity benefits.” Hines v. Barnhart,

(4th Cir. 2006). However, the scope of teview of such a decision is “extremely limited.” Frady v. Harris,

(4th Cir. 1981). “The courts ate not to try the case de novo.” Oppenheim v. Finch,

(4th Cir. 1974). Instead, “a reviewing court must uphold the factual findings of the AL] if they are supported by substantial evidence and were reached through application of the correct legal standard.” Hancock v. Astrue,

(4th Cir. 2012) (internal quotation omitted). “Substantial evidence means ‘such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.”’ Hunter v. Sullivan,

(4th Cir. 1993) (quoting Richardson v. Perales,

(1971)). “It consists of more than a mete

* Transcript citations refer to the Sealed Administrative Record [Doc. #8].

scintilla of evidence but may be somewhat less than a preponderance.” Mastro v. Apfel,

(4th Cir. 2001) (internal citations and quotation matks omitted). “If there is evidence to justify a refusal to direct a verdict were the case before a juty, then there is substantial evidence.” Hunter,

(internal quotation marks omitted). “In reviewing for substantial evidence, the court should not undertake to te-weigh conflicting evidence, make credibility determinations, or substitute its judgment for that of the [ALJ].” Mastro,

(internal brackets and quotation marks omitted). “Where conflicting evidence allows reasonable minds to differ as to whether a claimant is disabled, the responsibility for that decision falls on the ALJ.” Hancock,

. “The issue before [the reviewing court], therefore, is not whether [the claimant] is disabled, but whether the AL)’s finding that [the claimant] is not disabled is supported by substantial evidence and was reached based upon a correct application of the relevant law.” Craig v. Chater,

(4th Cir. 1996). In undertaking this limited review, the Court notes that “[a] claimant for disability benefits bears the burden of proving a disability.” Hall v. Harris,

(4th Cir. 1981). In this context, “disability” means the ““inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous of not less than 12 months.”

(quoting

(d)(1)(A)).3

3 “The Social Security Act comprises two disability benefits programs. The Social Security Disability Insurance Program (SSDI), established by Title II of the Act as amended,

et seq,, provides benefits to disabled petsons who have contributed to the program while employed. The Supplemental Security Income Program (SSI), established by Title XVI of the Act as amended,

et seq., provides benefits to indigent disabled persons. The statutory definitions and the regulations promulgated by the Secretary for

“The Commissioner uses a five-step process to evaluate disability claims.” Hancock,

(citing

(a)(4); 416.920(a)(4)). “Under this process, the Commissioner asks, in sequence, whether the claimant: (1) worked during the alleged period of disability; (2) had a severe impairment; (3) had an impairment that met or equaled the requirements of a listed impairment; (4) could return to her past relevant work; and (5) if not, could perform any other work in the national economy.”

A finding adverse to the claimant at any of several points in this five-step sequence forecloses a disability designation and ends the inquiry. For example, “[t]he first step determines whether the claimant is engaged in ‘substantial gainful activity.’ If the claimant is working, benefits are denied. The second step determines if the claimant is ‘severely’ disabled. If not, benefits are denied.” Bennett v. Sullivan,

(4th Cir. 1990). On the other hand, if a claimant catries his or her burden at the first two steps, and if the claimant’s impairment meets or equals a “listed impairment” at step three, “the claimant is disabled.” Mastro,

. Alternatively, if a clatmant cleats steps one and two, but falters at step three, te., “[i]f a claimant’s tmpairment is not sufficiently severe to equal or exceed a listed impairment,” then “the ALJ must assess the claimant’s residual functional capacity (RFC’).”

.4 Step four then requires the AL] to assess whether, based on

determining disability, see 20 C.F.R. pt. 404 (SSDI); 20 C-F.R. pt. 416 (SSI), governing these two programs ate, in all aspects relevant here, substantively identical.” Craig,

n.1. 4 “RFC is a measurement of the most a claimant can do despite [the claimant’s] limitations.” Hines,

(noting that administrative regulations requite RFC to reflect claimant’s “ability to do sustained work- related physical and mental activities tn a work setting on a regular and continuing basis . . . [which] means 8 hours a day, for 5 days a week, or an equivalent work schedule” (internal emphasis and quotation marks omitted)). The RFC includes both a “physical exertional or strength limitation” that assesses the claimant’s “ability to do sedentary, light, medium, heavy, or very heavy work,” as well as “nonexertional limitations (mental, sensory, or skin impaitments).” Hall,

. “RFC is to be determined by the AL] only after

that RFC, the claimant can “perform past relevant work”; if so, the claimant does not qualify as disabled. Id. at 179-80. However, if the claimant establishes an inability to return to prior wotk, the analysis proceeds to the fifth step, which “requires the [Government] to prove that

a significant number of jobs exist which the claimant could perform, despite the claimant’s impairments.” Hines,

. In making this determination, the ALJ must decide “whether the claimant is able to perform other work considering both [the clatmant’s RFC] and [the claimant’s] vocational capabilities (age, education, and past work experience) to adjust to a new job.” Hall,

. If, at this step, the Government cannot catty its “evidentiary burden of proving that [the claimant] remains able to work other jobs available in the community,” the claimant qualifies as disabled. Hines,

. Ill. DISCUSSION In the present case, the AL] found that Plaintiff had not engaged in “substantial gainful activity” since her alleged onset date. The ALJ therefore concluded that Plaintiff met her burden at step one of the sequential evaluation process. (Tr. at 19-20.)° At step two, the ALJ further determined that Plaintiff suffered from the following severe impairments: histoty of migtaine headaches; degenerative disc disease; osteoarthritis; and obesity|[-] (Ir. at 20-22.) The AL] found at step three that none of these impairments, individually or in combination, met ot equaled a disability listing. (Tr. at 22.) Therefore, the ALJ assessed

[the ALJ] considers all relevant evidence of a claimant’s impairments and any related symptoms (¢.g., pain).” Hines,

. 5 Despite this finding, the AL] noted at step one that Plaintiffs intermittent work as a Registered Nurse and English teacher in 2018 and 2019 “appear[ed] to rise to the level of substantial gainful activity.” (Ir. at 20.) Nevertheless, the ALJ “continue[d] with the remaining steps of the sequential evaluation for the periods after [Plaintiff] earned SGA.” (T'r. at 20.)

Plaintiffs RFC and determined that she could perform medium work with further limitations. Specifically, the AL] found that Plaintiff can petform frequent, but not constant overhead teaching; and can tolerate frequent, but not constant, exposure to extteme cold, pulmonary irritants, such as dust, fumes, odors, and gases, and work place hazards, such as unprotected heights and dangerous machinery. (Tr. at 22.) Based on this determination and the testimony of a vocational expert, the ALJ determined at step four of the analysis that Plaintiff remained capable of performing her past televant work as a Registered Nurse and as a Hospice Nurse. (Ir. at 25.) In addition, the AL] made an alternative finding at step five that, given Plaintiffs age, education, work experience, RFC, and the testimony of the vocational expert as to these factors, she could perform other jobs available in significant numbers in the national economy. (Tr. at 26-27.) Therefore, the AL) concluded that Plaintiff was not disabled under the Act. (It. at 27.) Plaintiff now challenges the ALJ’s decision in two respects. First, she argues that the AL} failed to “provide a logical bridge between the evidence and her conclusions” regarding the impact of Plaintiff's migraine headaches on her RFC. (PL’s Br. [Doc. #12] at 5.) Second, she contends that the ALJ failed to properly consider the effects of Plaintiffs depression and anxiety. In particular, she argues that the AL] erred in (1) finding these impairments non- sevete at step two of the sequential analysis and (2) failing to account for limitations from mental impairments when formulating the RFC assessment. (PL.’s Br. at 16.) After conducting a thorough review of the record, the Court concludes that the AL] provided sufficient explanation for her determinations, and that substantial evidence supports the ALJ’s conclusions.

A. Migtaine headaches Plaintiff first argues that the ALJ failed to conduct a proper function-by-function analysis of Plaintiffs migraine symptoms and their effect on her RFC. As Social Security Ruling (“SSR”) 96-8p instructs, “[t]he RFC assessment must first identify the individual’s functional limitations or testtictions and assess his or her work-related abilities on a function- by-function basis,” including the functions listed in the regulations. SSR 96-8p: Policy Interpretation Ruling Titles I] and XVI: Assessing Residual Functional Capacity in Initial Claims,

, at *1. “Only after such a function-by-function analysis may an ALJ exptess RFC in terms of the exertional levels of work.” Monroe v. Colvin,

(4th Cir. 2016) (internal quotations and citations omitted). Further, the “RFC assessment must include a nattative discussion describing how the evidence supports each conclusion, citing specific medical facts (e.g., laboratory findings) and nonmedical evidence (e.g., daily activities, obsetvations).” SSR 96-8p,

, at *7. An ALJ must “both identify evidence that supports his conclusion and build an accurate and logical bridge from [that] evidence to his conclusion.” Woods v. Berryhill,

(4th Cir. 2018) (emphasis omitted). The Fourth Citcuit has noted that a per se rule requiring remand when the ALJ does not perform an explicit function-by-function analysis “is inappropriate given that remand would

ptove futile in cases where the AL] does not discuss functions that are ‘irrelevant or uncontested.”’ Mascio v. Colvin,

(4th Cir. 2015) (quoting Cichocki v. Asttue,

(2d Cir. 2013) (per curiam)). Rather, remand may be appropriate “whete an ALJ fails to assess a claimant’s capacity to perform relevant functions, despite

conttadictory evidence in the record, or where other inadequacies in the AL]’s analysis frustrate meaningful review.” Mascio,

(quoting Cichocki,

). The court in Mascio concluded that remand was appropriate because it was “left to guess about how the ALJ arrived at his conclusions on [the claimant’s| ability to perform relevant functions” because the AL] had “said nothing about [the claimant’s] ability to perform them for a full workday,” despite conflicting evidence as to the claimant’s RFC that the ALJ did not address. Mascio,

. Here, Plaintiff argues that the ALJ’s failure to properly explain how the RFC assessment adequately addresses limitations relating to her migraine headaches renders her decision unsupported by substantial evidence. In her decision, the ALJ discusses at length the evidence in the record, including the evidence regarding Plaintiff's migraines, and concludes that, “[iJn limiting the [Plaintiff] to medium work, with additional environmental limitations, the [ALJ] has adequately accounted for the Plaintiffs history of migraine headaches.” (Tr. at 24.) ‘Those environmental limitations include limited exposure to extreme cold, pulmonary irritants, and workplace hazards. In reaching this conclusion, the ALJ relied on various factors including the record’s failure to substantiate Plaintiffs subjective complaints regarding the impact of her migraines on her RFC. With respect to the ALJ’s evaluation of Plaintiffs allegations regarding her symptoms, under the applicable regulations the ALJ’s decision must “contain specific reasons for the weight given to the individual’s symptoms, be consistent with and supported by the evidence, and be clearly articulated so the individual and any subsequent reviewer can assess how the adjudicator evaluated the individual’s symptoms.” Social Security Ruling 16-3p, Titles I] and

XVI: Evaluation of Symptoms in Disability Claims, SSR 16-3p,

, at *10 (Oct. 25, 2017) (“SSR 16-3p”); see also

. Moreover, in Arakas v. Comm’ of Soc. Sec.,

(4th Cir. 2020), the Fourth Circuit recently clarified the procedure an ALJ must follow when assessing a clatmant’s statements: When evaluating a claimant’s symptoms, ALJs must use the two-step framework set forth in

and SSR 16-3p,

(Mar. 16, 2016). First, the ALJ must determine whether objective medical evidence presents a “medically determinable impairment” that could reasonably be expected to produce the claimant’s alleged symptoms. 20 C.F .R. § 404.1529(b); SSR 16-3p,

, at *3. Second, after finding a medically determinable impairment, the AL] must assess the intensity and persistence of the alleged symptoms to determine how they affect the claimant’s ability to work and whether the claimant is disabled. See

(c); SSR 16-3p,

, at *4. At this step, objective evidence is mot requited to find the claimant disabled. SSR 16-3p,

, at *4-5. SSR 16-3p recognizes that “[s]ymptoms cannot always be measuted objectively through clinical or laboratory diagnostic techniques.”

. Thus, the ALJ must consider the entire case record and may “not disregard an individual’s statements about the intensity, persistence, and limiting effects of symptoms solely because the objective medical evidence does not substantiate” them.

. Arakas, 983 F.3d at 95-96. Thus, the second part of the test requires the ALJ to consider all available evidence in order to evaluate “the intensity and persistence of the claimant’s [symptoms], and the extent to which [they] affects [her] ability to work.” Craig,

. ‘This approach facilitates the AL]’s ultimate goal, which is to accurately determine the extent to which PlaintifPs pain or other symptoms limit her ability to perform basic work activities. Relevant evidence for this inquiry includes Plaintiffs “medical history, medical signs, and laboratory findings,” Craig,

, as well as the following factors set out in

(c)(3) and

: (1) [Plaintiffs] daily activities;

(11) The location, duration, frequency, and intensity of [Plaintiffs] pain or other symptoms; (iii) Precipitating and ageravating factors; (iv) The type, dosage, effectiveness, and side effects of any medication [Plaintiff] take[s] or [has] taken to alleviate [her] pain or other symptoms; (v) Treatment, other than medication, [Plaintiff] receives] or [has] received for relief of [her] pain or other symptoms; (vi) | Any measures [Plaintiff] use[s] or [has] used to relieve [her] pain or other symptoms (e.g., lying flat on [her] back, standing for 15 to 20 minutes every hour, sleeping on a board, etc.); and (vit) Other factors concerning [Plaintiffs] functional limitations and resttictions due to pain or other symptoms. In the present case, as instructed by the regulations, the ALJ considered the entire case record and explained the reasons for deviating from Plaintiff's statements regarding the impact of her headache symptoms on her ability to work. The AL] reviewed the medical evidence, Plaintiffs testimony, and other record evidence, such as Plaintiffs activities, in considering Plaintiffs subjective complaints. She then concluded that the extent to which Plaintiff's migraine symptoms limited her ability to work was not as extensive as Plaintiff alleged. In particular, the ALJ found as follows: [Plaintiff] has . .. been diagnosed with a history of migraine headaches. [She] has reported migraines since she was 18-years old. [Plaintiff] alleged daily migraines for a month after a motor vehicle accident in July 2018. She noted that they tapered off after the first 30 days. She has also reported doing extensive research into her conditions. She did not receive physical therapy or vestibular therapy after her accident. A head CT and brain MRI wete notmal.... On examination, [Plaintiff] generally presents with the following mostly normal findings: intact cranial nerves, intact processing speed, attention within normal ranges, intact sensation, alert, answer[s] questions appropriately, and oriented .... [She] has received mostly conservative treatment, including prescribed Botox, melatonin, Zonisamide, bulabital, cambia, and hydrocodone. [Plaintiff] has been noted as practicing yoga. [She] has also been noted as cating for her mother. [Plaintiff] has reported improvement in her headaches with Botox injections, including a greater than 50% reduction in her headaches. In March 2019, [Plaintiff] reported that her headaches were becoming less frequent. 10

Neutopsychological testing suggested possible symptom exaggeration. Additionally, [Plaintiff] has failed to report at additional neurological appointments. Ryan Conrad, M.D., noted in September 2019, that he did not “really understand why she is seeing me. She has filed for disability twice and has been tutned down, seems to want to be on disability from what I can gather and it seems she has been seeing doctors for this.” In limiting [Plaintiff] to medium work, with additional environmental limitations, the undersigned has adequately accounted for [Plaintiffs] history of migraine headaches. (Tr. at 23-24) (citing Tr. at 437, 730, 731, 2451). More generally, the ALJ noted that “[t]here ate many inconsistencies throughout the record. For example, [Plaintiff's] neuropsychological exam... suggested that she was exaggerating her symptoms and that her self-reported mood disorder should be interpreted with caution. [Treatment records] further noted that [Plaintiff] ‘wanted to be on disability.” (Tr. at 23) (citing Tr. at 731, 2451). Overall, the AL] concluded that Plaintiffs impairments were “less limiting than alleged.” (Tr. at 23.) Thus, the AL] here gave multiple reasons for finding Plaintiffs migraines less limiting that Plaintiff alleged. First, the AL) noted significant credibility issues regarding Plaintiffs claims, based on the inconsistencies in the record and the assessment of both Dr. Harris and Dr. Contad. On this point, the ALJ noted that Dr. Hartis’s “[n]europsychological testing suggested possible symptom exaggeration.” (Ir. at 24, 729-34.) Specifically, Dr. Harris included a symptom validity test as part of the neuropsychological testing, and Plaintiffs “performance actoss a stand-alone symptom validity measute was well below expectation and suggestive of possible symptoms exaggeration.” (Tr. at 731.) In addition, the ALJ also noted that “Ryan Conrad, M.D. noted in September 2019, that he did not ‘really understand why she is seeing me. She has filed for disability twice and has been turned down, seems to want to be

on disability from what I can gather and it seems she has been seeing doctors for this.”” (Ir. at 24, 2451). The AL] expressly telied on these assessments in evaluating the credibility of 11

Plaintiff's claims of debilitating symptoms from migraines, and in concluding that Plaintiffs “4mpairments ate less limiting than alleged.” (T'r. at 23-24.) Second, the ALJ noted that the evidence in the medical records did not support Plaintiffs claims of disabling symptoms. The AL] noted that “[a] head CT’ and a brain MRI

were notmal” and the examinations generally reflect “mostly normal findings: intact cranial

netves, intact processing speed, attention within normal ranges, intact sensation, alert, answer questions appropriately, and oriented.” (Tr. at 24, 438, 446, 515, 609, 651, 731-32, 736, 748, 2463.) Third, the AL} noted that Plaintiff received mostly conservative treatment, which is not consistent with the degtee of debilitating symptoms Plaintiff alleged. (Ir. at 24, 494, 748.) Fourth, the ALJ further noted that Plaintiff failed to take advantage of other available and recommended treatment, including by failing to report for additional neurological appointments and failing to seek out physical therapy or vestibular treatment that was recommended by Dr. Harttis. (Tr. at 23-24, 732.) Fifth, the AL] noted that the medical records teflected a significant improvement in her migraines with medication, with a substantial reduction in frequency. (Tr. at 24, 702-04, 734, 741, 743.) Sixth, the AL] noted Plaintiffs activities despite her claim of disabling migraines, including practicing yoga, driving long distances, using the internet including for doing extensive reseatch into her conditions, vatious crafts, and caring for her family. Medical records reflect that Plaintiff told providers she took care of her elderly mother, disabled sister, and schizophrenic son. (Tt. at 23-24, 516.) In addition, the ALJ noted that Plaintiff worked

as a nutse from November 2018 to January 2019 at Cabarrus Gastroenterology, during the petiod of claimed disability, but left to file for unemployment, and she continued to take

12

Continuing Education to renew her RN license in 2019. (Tr. at 20, 23-24.) Plaintiff contends that the ALJ failed to include or consider qualifying statements regarding her activities. However, as noted by Defendant, the ALJ did consider and include the qualifying statements regarding her activities, including her alleged difficulties remembering and concentrating, panic attacks while driving, and difficulties with dizziness (Ir. at 23), but still found that Plaintiffs activities wete inconsistent with her claim of disabling migraines. The ALJ also considered the opinion evidence of the State Agency physicians, who opined that Plaintiff was capable of medium work with environmental limitations. (It. at 24.) Plaintiff does not point to any contrary opinion evidence from her physicians that her migtaines ate disabling or otherwise cause work-related limitations.° Although Plaintiff contends that the AL] should have included limitations in the RFC to account for work breaks ot absences related to her migtaines, the AL] gave multiple reasons to conclude that the evidence did not support the severity of symptoms claimed by Plaintiff, as set out above. The AL} ultimately concluded that Plaintiffs history of migraine headaches was adequately accounted fot with the limitation to medium work with additional environmental limitations. Those environmental limitations include limitations on exposure to extreme cold, pulmonary irritants including odors, and workplace hazards such as unprotected heights and dangerous machinety, which is consistent with Plaintiffs testimony that her migraines varied depending on “the weather” and “scents,” as well as her concerns of dizziness. (Tr. at 22, 70.)

® Plaintiff does point to a family leave form covering a brief two-week period from July 26, 2018 to August 6, 2018, immediately after her vehicle accident. (Tr. at 601-02.) However, soon after, her doctor signed a “return to work” form on August 23, 2018, opining that Plaintiff could be released to work at “full, unrestricted duty.” (Tt. at 625.) 13

Thus, the ALJ explained the basis for the decision sufficiently to allow the Court to follow the reasoning, and substantial evidence supports that determination. Whether the ALJ could have reached a different conclusion based on the evidence is irrelevant. The sole issue before the Court is whether substantial evidence supports the ALJ’s decision. See Blalock v. Richardson,

(4th Cir. 1972) (“[I]he language of § 205(g) precludes a de novo judicial proceeding and requires that the court uphold the Secretaty’s decision even should the coutt disagree with such decision as long as it is supported by ‘substantial evidence.”’). B. Anxiety and Depression Plaintiff next contends that the AL]’s erred at step two of the sequential analysis in finding that Plaintiff's anxiety and depression wete non-sevete impairments. (Pl.’s Br. at 16.) She futther contends that the AL]’s failure to account for these impairments at later steps tenders the RFC unsupported by substantial evidence. At step two, the ALJ identified four

sevete impairments: “history of migraine headaches; degenerative disc disease; osteoarthritis; and obesity.” (Ir. at 20.) The AL] further identified six additional physical impairments as non-severe, along with the two mental impairments now in question. (Tr. at 20.) In finding that Plaintiffs depression and anxiety did not cause more than minimal limitations in her ability to perform basic work activities, the ALJ noted that, while Plaintiff presented with “anxious affect and abnormal mood” at times, her examinations revealed “mostly normal findings,” and her treatment has been conservative, “including psychotherapy and prescribed alprazolam, Xanax, Lamictal, and Cymbalta,” and she had “significant activities of daily living.” (Tr. at 24.)

14

At step two, the ALJ also included a discussion of the four broad functional ateas of mental functioning set out in the regulations for evaluating mental impairments, commonly known as “patagraph B” criteria. These functional areas are understanding, remembering and applying instructions; interacting with others; concentrating, persisting, or maintaining pace; and adapting ot managing oneself. In the present case, the AL] concluded that Plaintiff had mild limitations in each of these areas. The AL] included the following explanation of her findings regarding Plaintiffs mental functioning: [Plaintiff] alleged that she has difficulties remembering and concentrating. However, on mental status examination, [Plaintiff] generally presents with mostly normal findings, including alert, oriented, cooperative, normal judgment, appropriately dressed, well-groomed, good hygiene, good eye contact, intact absttact reasoning, good insight, normal gait, normal behavior, normal mood, and normal affect. Additionally, [Plaintiff] reports that she is able to live with her family, use the internet, use social media, reseatch medical treatment, craft, take care of plants, basket weave, make jewelty, vacuum for shott periods, read, and drive a car. [Plaintiff] also reported working after the alleged onset date, as well as attempting to work as an English as a second language instructor. She noted that she helps take care of her son who has been diagnosed with schizophrenia. In addition, [Plaintiff] took her continuing education courses for her RN license in early 2019, and then renewed het RN license in November of 2019. (Tr. at 21) (citing Tr. at 438, 470, 507, 515, 518, 593, 660, 667, 736, 748, 763, 2373, 2435, 2436, 2444, 2454, 2456, 2462). The ALJ, citing

.1520a(d)(1) and 416.920a(d)(1), concluded that “[b]ecause [Plaintiffs] medically detetminable mental impaitments cause no more than ‘mild’ limitation in any of the functional ateas and the evidence does not otherwise indicate that there is more than a minimal limitation in [her] ability to do basic work activities, they are nonseverte.” (Tr. at 21.) In making these findings, the AL] further noted that “[t]he limitations identified in the “paragraph B” criteria are not [an RFC] assessment,” and that the mental RFC “assessment 15

used at steps 4 and 5 of the sequential analysis requires a more detailed assessment.” (I't. at 21.) The ALJ then further discussed Plaintiffs mental impairments in setting the RFC, and set out het reasons for discounting Plaintiffs statements concerning the limiting effects of her symptoms. (See Tr. at 23.) Plaintiff contends that the ALJ erred by finding Plaintiffs mental impairments non- sevete and by failing to include them in the RFC. Plaintiff notes that the ALJ relied on Plaintiffs activities but failed to consider Plaintiffs testimony qualifying her abilities to engage in those activities. Plaintiff also contends that it was error for the AL] to rely on the normal examination findings, without considering the contraty findings including in particular the assessments and neuropsychological testing by Dr. Harris. Finally, the ALJ points to the opinions of the State Agency psychological consultants, who found moderate limitations in

some ateas and limited Plaintiff to “simple work.” Plaintiff argues that including these limitations would have precluded her teturn to past work and/or transferability of skills resulting in a finding of disability. However, the AL] provided multiple reasons and extensive explanation for reaching her conclusions. First, the AL] noted significant credibility issues regarding Plaintiffs claims, based on the inconsistencies in the record and the assessments of both Dr. Harris and Dr. Conrad. On this point, the ALJ noted that Plaintiffs “neuropshychological exam indicated that it was suggested that she was exaggerating her symptoms and that her self-reported mood disorder should be interpreted with caution.” (I'r. at 23, 729-34.) Specifically, as noted above, Dr. Hattis included a symptom validity test as part of the neutropsychological testing, and Plaintiffs “performance across a stand-along symptom validity measure was well below

16

expectation and suggestive of possible symptoms exaggeration.” (Ir. at 731.) Plaintiffs depression and anxiety findings were based on “self-reported mood measures” to be “fnterpreted with caution.” (Tr. at 731.) The ALJ also relied on Dr. Conrad’s assessment that Plaintiff was seeing doctors because she “seems to want to be on disability.” (Tr. at 23, 2451.) In addition, the ALJ noted specific instances that reflected a lack of credibility, such as Plaintiff reporting “spending an entire month in bed,” when the remainder of the evidence in the tecotd showed otherwise, including medical appointments scheduled during that time. (I'r. at 21.) Second, the ALJ telied on the examination records reflected “mostly normal” mental status examinations including “alert, oriented, cooperative, normal judgment, appropriately dressed, well-groomed, good hygiene, good eye contact, intact abstract reasoning, good insight, normal gait, normal behavior, normal mood, and normal affect.” (Ir. at 21.) Plaintiff points to other records showing depression and anxiety and related symptoms, particularly the assessments and related limitations from Dr. Harris. However, as noted above, the AL] specifically addressed Dr. Harris’ assessment and relied on Dr. Harris’ warning that Plaintiffs “self-reported mood disorder” which included the anxiety and depression assessment, should be considered with caution and reflected symptom exaggeration. Third, the ALJ relied on Plaintiffs activities, including living with her family, using the internet, using social media, researching medical treatment, crafting, taking care of plants, basket weaving, making jewelry, vacuuming for shore periods, reading, and driving a car. (Tr. at 21; see also Tr. at 2443.) The AL] also referenced Plaintiffs continued work activity after the alleged onset date and her ability to care for her son who has been diagnosed with

17

schizophrenia, as well as her decision to take continuing education courses and renew her RN license in September 2019. (Tr. at 21.) The ALJ reasonably relied on the evidence in the record reflecting that Plaintiff maintained the mental abilities required for these activities. The AL) also noted Plaintiffs qualifying testimony that she had panic attacks when driving and difficulty remember and concentrating due to a traumatic brain injury (Tr. at 23), but the ALJ also noted that there was “no objective medical abnormality related to a traumatic brain injuty,” with a “negative head CT” and “normal neurological examination findings.” (Tr. at 21-22.) ‘Thus, the ALJ considered Plaintiffs testimony regarding those activities, and addressed those contentions in the context of the evidence in the record. Finally, the AL] considered the evidence again in making a determination that the State agency psychological consultants’ opined mental limitations were unpersuasive (Tr. at 24). The State agency psychologists found Plaintiff had some moderate limitations in the “patagtaph B” functional areas and opined that, as a result, she was “limited to understanding and remembering short and simple instructions, sustaining sufficient attention to complete simple routine tasks with normal breaks, working in a setting with minimal social demands, and managing a stable work assignment in a setting with minimal changes in routine.” (Tr. at 24.) The ALJ found that these opinions were not persuasive because they were “inconsistent with, and unsupported by, [Plaintiffs] mostly normal progtess reports, activities of daily living, treatment history, and examination findings.” (Tr. at 24-25.) Those findings are further explained throughout the decision, as discussed at length above, and notably the ALJ relied

18

on the reports from Plaintiffs physicians Dr. Harris and Dr. Conrad as part of that determination and explanation.’ Plaintiff essentially asks the Court to reconsider and re-weigh the evidence presented. However, it is not the function of this Court to re-weigh the evidence or reconsider the AL]’s determinations if they are supported by substantial evidence. As noted above, “[w]here conflicting evidence allows reasonable minds to differ as to whether a claimant is disabled, the responsibility for that decision falls on the ALJ.” Hancock,

(quotation omitted). Thus, the issue before the Court is not whether a different fact-finder could have drawn a different conclusion, or even “whether [Plaintiff] is disabled,” but rather, “whether the AL]’s finding that [Plaintiff] is not disabled is supported by substantial evidence and was reached based upon a correct application of the relevant law.” Craig,

. Hete, the ALJ reviewed the evidence, explained her decision, and clearly explained the reasons for her determination. That determination is supported by substantial evidence in the record. Plaintiff has not identified any errors that require remand, and Plaintiff's Motion to Reverse the Decision of the Commissioner should therefore be denied. IT IS THEREFORE RECOMMENDED that the Commissionet’s decision finding no disability be AFFIRMED, that PlaintifPs Motion for Summary Judgment [Doc. #11] be

To the extent Plaintiff contends that a finding limiting her to simple work would render her disabled because she could not return to her past work or have transferrable skills, Defendant has noted that such a finding would not have rendered her disabled under the Grids, and has further noted that the ALJ made an alternative finding that Plaintiff would be able to perform the requirements of unskilled work such as Store Laborer, Hand Packager, and Dining Room Attendant. (Ir. at 26-27.) The Court need not consider that issue further, given that there is substantial evidence supporting the AL]’s determination as discussed above. 19

DENIED, that Defendant’s Motion for Judgment on the Pleadings [Doc. #13] be GRANTED, and that this action be DISMISSED with prejudice. This, the 1st day of September, 2022. /s/ Jot Elizabeth Peake United States Magistrate Judge

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