Stitzlein v. Commissioner of Social Security

IN THE UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF OHIO
EASTERN DIVISION
TINA MARIE STITZLEIN,
Plaintiff,
vs.
COMMISSIONER OF SOCIAL
SECURITY,
Defendant.
CASE NO. 1:25-cv-808
DISTRICT JUDGE
BENITA Y. PEARSON
MAGISTRATE JUDGE
JAMES E. GRIMES JR.
REPORT &
RECOMMENDATION
Plaintiff 	Tina 	Marie 	Stitzlein 	filed 	a 	Complaint 	against 	the
Commissioner of Social Security seeking judicial review of the Commissioner’s
decision denying disability insurance benefits and supplemental security
income. This Court has jurisdiction under 42 U.S.C. §§ 405(g) and 1383(c). The
Court referred this matter to a Magistrate Judge under Local Rule 72.2(b)(1)
for the preparation of a Report and Recommendation. Following review, and
for the reasons stated below, I recommend that the District Court affirm the
Commissioner’s decision.
Procedural history
In July 2022, Stitzlein filed applications for disability insurance benefits
and supplemental security income, alleging a disability onset date of May 9,
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2022.1 	Tr. 	17. 	In 	her 	applications, 	Stitzlein 	claimed 	disability 	due 	to
rheumatoid 	arthritis, 	fibromyalgia, 	radiculopathy, 	spinal 	stenosis, 	and
neuropathy. Tr. 285. The Social Security Administration denied Stitzlein’s
applications and her motion for reconsideration. Tr. 59–60, 85, 96. Stitzlein
then requested a hearing before an Administrative Law Judge (ALJ). Tr. 130.
In February 2024, an ALJ held a hearing, during which Stitzlein and a
vocational expert testified. Tr. 35–58. In April 2024, the ALJ issued a written
decision finding that Stitzlein was not disabled. Tr. 17–29. The ALJ’s decision
became final on March 17, 2025, when the Social Security Appeals Council
declined further review. Tr. 1–3; see 20 C.F.R. § 404.981.
Stitzlein filed this action on April 22, 2025. Doc. 1. She asserts the
following assignments of error:
1. Whether the ALJ erred by assessing an RFC
which 	does 	not 	address 	the 	Fuchs’ 	Corneal
Dystrophy that she found severe at Step 2.
2. Whether the ALJ failed to properly evaluate
Plaintiff’s allegations in accordance with SSR 16-3p.
Doc. 9, at 3.
1 	“Once a finding of disability is made, the [agency] must determine the
onset date of the disability.” McClanahan v. Comm’r of Soc. Sec., 193 F. App’x
422, 425 (6th Cir. 2006).
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Evidence
Personal and vocational evidence
Stitzlein was 51 years old on her alleged disability onset date. Tr. 28.
She obtained a GED and last worked in 2022. Tr. 286.
Relevant medical evidence
In September 2021, Stitzlein visited her family medicine office and
reported a flare-up of her back pain. Tr. 419. She took Ibuprofen and Tylenol,
which provided some relief. Tr. 419. Stitzlein denied radiating pain, numbness
or tingling, loss of feeling, or leg weakness. Tr. 419. On exam, she had lumbar
spine tenderness but no swelling or deformity, a normal range of motion, full
strength, normal coordination, and a normal gait. Tr. 419. Straight-leg raise
testing was negative. Tr. 419.
In December 2022, Stitzlein saw James Gatton, M.D., for a consultative
exam. Tr. 447–54. Stitzlein described back pain that occasionally radiated
down her legs. Tr. 453. She also reported knee pain. Tr. 453. She denied
weakness, numbness, or lack of coordination. Tr. 453. On exam, Stitzlein’s
visual acuity was 20/25 in the left eye and 20/25 in the right eye with
correction.2 Tr. 453. Stitzlein’s pupils were “round and reactive to light and
2 	“The visual acuity test is used to determine the smallest letters you can
read on a standardized chart … or a card held 20 feet (6 meters) away.” See
https://medlineplus.gov/ency/article/003396.htm 	[https://perma.cc/J7MA-
KM4E]. “Visual acuity is expressed as a fraction. The top number refers to the
distance you stand from the chart. This is often 20 feet (6 meters). The bottom
number indicates the distance at which a person with normal eyesight could
read the same line you correctly read.” Id. “For example, 20/20 (6/6) is
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accommodation,” her extraocular movements were intact, and her visual fields
were “full to confrontational testing.” Tr. 454. Stitzlein was able to get on and
off the exam table unassisted and without difficulty and she walked without
using an assistive device but with a “hobbled gait.” Tr. 453–54. She was able
to heel-and-toe walk, walk on her heels, and walk on her toes. Tr. 454. She
could not hop or squat. Tr. 454. Stitzlein exhibited full upper and lower
extremity strength and normal reflexes and sensation. Tr. 454. She had a
reduced range of motion in both hips and in her lumbar spine. Tr. 450–51. Dr.
Gatton concluded that Stitzlein could walk for three to four hours in an eight-
hour day and could “probably” be on her feet for a combined total of three to
four hours. Tr. 454. Stitzlein could “probably” carry less than 10 pounds
frequently and more than 20 pounds occasionally. Tr. 454. Dr. Gatton also
wrote that Stitzlein had “limitations” with crawling, kneeling, crouching,
climbing, stooping, and bending. Tr. 454.
In March 2023, Stitzlein saw Richard Marquardt, O.D., at Ohio Eye
Associates. Tr. 458. Stitzlein reported blurred vision and eye dryness. Tr. 458.
She also said that she avoided bright lights and going out at night. Tr. 458.
Stitzlein’s eye exam showed that she had “Map-Dot Fingerprint Changes” in
both corneas and “Few Scattered Vacuole” in both lenses. Tr. 460. Dr.
considered normal. 20/40 (6/12) indicates that the line you correctly read at 20
feet (6 meters) away can be read by a person with normal vision from 40 feet
(12 meters) away.” Id.
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Marquardt diagnosed Fuchs’ corneal dystrophy3 in both eyes. Tr. 460. He
advised Stitzlein to call immediately if she experienced “new distortion,
blurring, decreased vision or eye pain.” Tr. 461. She was to monitor her
condition and return in one year. Tr. 460. Dr. Marquardt prescribed corrective
eyeglasses for Stitzlein’s presbyopia (blurriness of near objects) and hyperopia
(farsightedness). Tr. 461.
In July 2023, Stitzlein visited her family medicine office complaining of
joint pain. Tr. 471. At the time of her visit, Stitzlein had pain in her lower back
and right knee, which had flared up a month or two before the visit. Tr. 471.
Her exam findings showed tenderness in her lower back and right knee. Tr.
471. She had a normal range of motion, a normal gait, and negative straight-
leg 	raise 	testing. 	Tr. 	471–72. 	Stitzlein 	was 	assessed 	with 	multilevel
degenerative 	disc 	disease, 	positive 	ANA 	(antinuclear 	antibody), 	chronic
bilateral lower back pain without sciatica, and chronic knee pain, for which she
was prescribed lidocaine pain patches. Tr. 472. The provider also administered
a steroid injection intramuscularly. Tr. 472.
Two days later, Stitzlein had a rheumatology appointment. Tr. 466. She
reported pain in her right knee, right hip, and lower back. Tr. 466. She also
reported fatigue, dry eyes and mouth, joint pain, a rash, and weakness. Tr.
3 	Fuchs’ corneal dystrophy is a disease of the cornea in which cells
gradually die, fluid builds up, and the cornea becomes thickened, effecting
vision. 	See 	https://www.lei.org.au/services/eye-health-information/fuchs-
dystrophy/ [https://perma.cc/47Q9-2UVL].
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466. Stitzlein’s exam findings showed tenderness, decreased strength, or
decreased range of motion in her shoulders, right elbow, right forearm, wrists,
hands, neck, back, knees, and ankles. Tr. 468. The doctor diagnosed Stitzlein
with, 	among 	other things, 	“Sjogren’s 	syndrome 	with 	keratoconjunctivitis
sicca,” an autoimmune disorder that causes dry eyes; unspecified fatigue; and
a history of rheumatoid arthritis and lupus. Tr. 468. He prescribed physical
therapy and noted that Stitzlein applied eye drops prescribed by her eye doctor.
Tr. 469. At this visit, Stitzlein was taking Tylenol and Naproxen prescribed by
her primary care doctor, and she said that she had tried Flexeril but stopped
taking it because she didn’t like the way it made her feel. Tr. 469. The
rheumatologist advised that if Stitzlein continued to have back pain he would
recommend a referral to a spine surgeon or pain management, and if she
continued to have trouble with her knees, he would recommend an orthopedic
evaluation. Tr. 469.
A January 2024 x-ray of Stitzlein’s lumbar spine showed mild scoliosis
and minor degenerative changes with stable spurring and no progressive disc
space narrowing. Tr. 510.
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State agency opinions4
In January 2023, Dana Schultz, M.D., reviewed Stitzlein’s record. Tr.
64–67. Regarding Stitzlein’s physical residual functional capacity (RFC),5 Dr.
Schultz determined that Stitzlein could sit, stand, and walk for up to six hours
in 	an 	eight-hour 	workday. 	Tr. 	65. 	She 	could 	lift 	and 	carry 	20 	pounds
occasionally and 10 pounds frequently. Tr. 65. Dr. Schultz also found that
Stitzlein had postural and environmental limitations. Tr. 66.
In March 2023, Steve McKee, M.D., reviewed Stitzlein’s record and
affirmed Dr. Schultz’s findings. Tr. 92.
Hearing testimony
Stitzlein, who was represented by counsel, testified at the telephonic
administrative hearing held in February 2024. Stitzlein stated that she last
worked in 2022 in a factory. Tr. 40, 42. For that job, Stitzlein mostly stood or
walked and she lifted and carried between 50 to 70 pounds. Tr. 42. Since then,
4 	When a claimant applies for disability benefits, the State Agency creates
a record. The record includes the claimant’s medical evidence. A State Agency
disability examiner and a State Agency physician or psychologist review the
claimant’s record and determine whether and to what extent the claimant’s
condition affects his or her ability to work. If the State Agency denies the
claimant’s 	application, 	the 	claimant 	can 	ask 	for 	reconsideration. 	On
reconsideration, the State Agency updates the record and a second disability
examiner and doctor review the file and make a new determination. See, e.g.,
20 C.F.R. § 404.1615.
5 	An RFC is an “‘assessment of’” a claimant’s ability to work, taking his or
her “limitations … into account.” Howard v. Comm’r of Soc. Sec., 276 F.3d 235,
239 (6th Cir. 2002) (quoting 20 C.F.R. § 416.945). Essentially, it’s the SSA’s
“description of what the claimant ‘can and cannot do.’” Webb v. Comm’r of Soc.
Sec., 368 F.3d 629, 631 (6th Cir. 2004) (quoting Howard, 276 F.3d at 239).
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she had tried to work a job putting pipes together, but it involved standing and
it hurt her back. Tr. 41. She also worked for a short time as a receptionist, but
the job ended because they no longer needed her. Tr. 42. Because it required a
lot of sitting, Stitzlein wasn’t sure if she could have continued to work at that
job. Tr. 41. She explained that she can’t sit or stand for long periods of time.
Tr. 42.
Stitzlein testified that that she has a driver’s license, she has no driving
restrictions, and she regularly drives. Tr. 44. When asked what prevents her
from working, Stitzlein said that it’s hard for her to focus due to pain. Tr. 45.
She experiences pain in her lower back down by her tailbone and rated her
pain, on average, a seven-to-eight out of ten. Tr. 45–46. She estimated that she
could stand for 10 to 15 minutes. Tr. 45. Pain interferes with her ability to
sleep. Tr. 45.
Stitzlein stated that she has good days and bad days. Tr. 46. On bad
days, her pain level is higher and she needs help getting out of bed. Tr. 46. This
happens about four days a week. Tr. 46. She takes medication, applies pain
patches, and uses a heating pad, which help. Tr. 46. Stitzlein attends physical
therapy a few times a week, which also helps. Tr. 47. She sees a pain
management doctor. Tr. 47. She does some household chores, but is limited due
to back pain and having to change positions. Tr. 49.
When asked about her vision problems, Stitzlein stated that she has dry
eyes. Tr. 50. This causes blurriness, and she sees spots. Tr. 50–51. She wears
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glasses with strong bifocals. Tr. 51. When asked if she had vision problem while
wearing her eyeglasses, Stitzlein said that sometimes, if she “get[s] the little
spots,” she will close her eyes and sit for a little bit. Tr. 51.
The ALJ discussed with the vocational expert Stitzlein’s past work as
an assembler and hand packager. Tr. 52. The ALJ asked the vocational expert
to determine whether a hypothetical individual with Stitzlein’s age, education,
and work experience could perform Stitzlein’s past work or any other work if
the individual had the limitations assessed in the ALJ’s RFC determination,
described below. Tr. 53–55. The vocational expert answered that such an
individual could not perform Stitzlein’s past work, but could perform the
following 	jobs: 	merchandise 	marker, 	routing 	clerk, 	and 	small 	products
assembler. Tr. 55.
The ALJ’s Decision
The ALJ made the following findings of fact and conclusions of law:
1. 	The 	claimant 	meets 	the 	insured 	status
requirements of the Social Security Act through
December 31, 2027.
2. The claimant has not engaged in substantial
gainful activity since May 9, 2022, the alleged onset
date (20 CFR 404.1571 et seq., and 416.971 et seq.).
3. 	The 	claimant 	has 	the 	following 	severe
impairments: 	degenerative 	disc 	disease 	of 	the
lumbar 	spine; 	fibromyalgia; 	Fuchs’ 	corneal
dystrophy; depressive disorder; and anxiety disorder
(20 CFR 404.1520(c) and 416.920(c)).
4. The claimant does not have an impairment or
combination of impairments that meets or medically
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equals the severity of one of the listed impairments
in 20 CFR Part 404, Subpart P, Appendix 1 (20 CFR
404.1520(d), 	404.1525, 	404.1526, 	416.920(d),
416.925 and 416.926).
5. After careful consideration of the entire record,
the undersigned finds that the claimant has the
residual functional capacity to perform light work as
defined 	in 	20 	CFR 	404.1567(b) 	and 	416.967(b)
except: the claimant can stand and/or walk four
hours in an eight hour workday; can never climb
ladders, ropes, or scaffolds; can occasionally climb
ramps and stairs; can occasionally stoop, kneel,
crouch, and crawl; and must avoid exposure to all
hazards 	including 	unprotected 	heights, 	heavy
machinery, and commercial driving. The claimant
can understand, remember, and carryout simple
instructions; 	cannot 	perform 	work 	requiring 	a
specific production rate such as assembly line work
or work that requires hourly quotas; and can deal
with occasional changes in a routine work setting.
6. 	The 	claimant 	is unable 	to 	perform 	any 	past
relevant work (20 CFR 404.1565 and 416.965).
7. The claimant was … 51 years old, which is defined
as an individual closely approaching advanced age,
on 	the 	alleged 	disability 	onset 	date 	(20 	CFR
404.1563 and 416.963).
8. The claimant has at least a high school education
(20 CFR 404.1564 and 416.964).
9. Transferability of job skills is not an issue in this
case because the claimant’s past relevant work is
unskilled (20 CFR 404.1568 and 416.968).
10. Considering the claimant’s age, education, work
experience, and residual functional capacity, there
are jobs that exist in significant numbers in the
national economy that the claimant can perform (20
CFR 404.1569, 404.1569a, 416.969, and 416.969a).
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11. The claimant has not been under a disability, as
defined in the Social Security Act, from May 9, 2022,
through 	the 	date 	of 	this 	decision 	(20 	CFR
404.1520(g) and 416.920(g)).
Tr. 19–29.
Standard for Disability
Eligibility for social security benefit payments depends on the existence
of a disability. 42 U.S.C. §§ 423(a), 1382(a). “Disability” is defined as the
“inability to engage in any substantial gainful activity by reason of any
medically determinable physical or mental impairment which can be expected
to result in death or which has lasted or can be expected to last for a continuous
period of not less than 12 months[.]” 42 U.S.C. § 423(d)(1)(A); see also 42 U.S.C.
§ 1382c(a)(3)(A).
An ALJ is required to follow a five-step sequential analysis to make a
disability determination:
1. 	Is the claimant engaged in substantial gainful
activity? If so, the claimant is not disabled.
2. 	Does 	the 	claimant 	have 	a 	medically
determinable impairment, or a combination of
impairments, 	that 	is 	“severe”? 	If 	not, 	the
claimant is not disabled.
3. 	Does the claimant’s impairment meet or equal
one of the listed impairments and meet the
duration requirement? If so, the claimant is
disabled. If not, the ALJ proceeds to the next
step.
4. 	What is the claimant’s residual functional
capacity and can the claimant perform past
relevant 	work? 	If 	so, 	the 	claimant 	is 	not
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disabled. If not, the ALJ proceeds to the next
step.
5. 	Can 	the 	claimant 	do 	any 	other 	work
considering the claimant’s residual functional
capacity, 	age, 	education, 	and 	work
experience? If so, the claimant is not disabled.
If not, the claimant is disabled.
20 C.F.R. §§ 404.1520, 416.920. see Jordan v. Comm’r of Soc. Sec., 548 F.3d
417, 422 (6th Cir. 2008). Under this sequential analysis, the claimant has the
burden of proof at steps one through four. Jordan, 548 F.3d at 423. The burden
shifts to the Commissioner at step five “to prove the availability of jobs in the
national economy that the claimant is capable of performing.” Id. “The
claimant, however, retains the burden of proving her lack of residual functional
capacity.” Id. If a claimant satisfies each element of the analysis and meets the
duration requirements, the claimant is determined to be disabled. Walters
Comm’r of Soc. Sec., 127 F.3d 525, 529 (6th Cir. 1997).
Standard of review
A reviewing court must affirm the Commissioner’s conclusions unless it
determines “that the ALJ has failed to apply the correct legal standards or has
made findings of fact unsupported by substantial evidence in the record.”
Jordan, 548 F.3d at 422. “‘[S]ubstantial evidence’ is a ‘term of art’” under which
“a court … asks whether” the “existing administrative record … contains
‘sufficien[t] evidence’ to support the agency’s factual determinations.” Biestek
v. Berryhill, 587 U.S. 97, 102 (2019) (citations omitted). The substantial
evidence standard “is not high.” Id. at 103. Substantial evidence “is ‘more than
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a mere scintilla’” but it “means only[] ‘such relevant evidence as a reasonable
mind might 	accept 	as 	adequate 	to 	support 	a 	conclusion.’” 	Id. 	(citations
omitted). The Commissioner’s “findings … as to any fact if supported by
substantial evidence [are] conclusive.” 42 U.S.C. § 405(g); Biestek, 587 U.S. at
99.
A court may “not try the case de novo, resolve conflicts in evidence, or
decide questions of credibility.” Bass v. McMahon, 499 F.3d 506, 509 (6th Cir.
2007). Even if substantial evidence or a preponderance of the evidence
supports 	a 	claimant’s 	position, 	a 	reviewing 	court 	cannot 	overturn 	the
Commissioner’s decision “so long as substantial evidence also supports the
conclusion reached by the ALJ.” Jones v. Comm’r of Soc. Sec., 336 F.3d 469,
477 (6th Cir. 2003). This is so because there is a “zone of choice within which”
the Commissioner can act, without fear of judicial “interference.” Lindsley v.
Comm’r of Soc. Sec., 560 F.3d 601, 605 (6th Cir. 2009) (quoting Felisky v.
Bowen, 35 F.3d 1027, 1035 (6th Cir. 1994)).
Discussion
1. The ALJ did not err when evaluating Stitzlein’s vision impairment
Stitzlein argues that the ALJ erroneously “assess[ed] an RFC which
does not address the Fuchs’ Corneal Dystrophy that she found severe at Step
2.” Doc. 9, at 12.6 As a result, Stitzlein alleges, the RFC is “legally flawed as it
6 	In this report and recommendation, all of the citations to the docket refer
to the ECF document and page number shown at the top of the page.
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did not address all of Plaintiff’s limitations.” Id. But the ALJ’s RFC assessment
included a restriction that Stitzlein “must avoid exposure to all hazards
including unprotected heights, heavy machinery, and commercial driving,” Tr.
23, which, the ALJ explained, accounts for Stitzlein’s “visual impairment,” Tr.
26. So the ALJ accounted for Stitzlein’s Fuchs’ corneal dystrophy in the RFC
assessment.
Next, Stitzlein argues that this limitation didn’t adequately address
Stitzlein’s Fuchs’ corneal dystrophy. Doc. 9, at 13. Stitzlein concedes that the
ALJ “correctly notes” that Stitzlein “testified that she has chronically dry eyes
and [occasionally] sees ‘little spots’ which require her to sit down [for a little
bit].” Id. (citing Tr. 23). But, Stitzlein contends, she also testified that “her
condition causes blurriness and spots which make it so that she ‘can’t see,’ thus
necessitating that she sit down and close her eyes until her vision returns.” Tr.
50–51. While Stitzlein testified that her eye impairment causes blurriness, she
also stated that as a result she has “pretty strong” “bifocals.” Tr. 51. The ALJ
asked about Stitzlein’s vision while wearing her glasses, and Stitzlein stated
that she “sometimes” sees “the little spots, the twinkle things I can’t see, and I
just keep my eyes closed and sit down for a little bit.” Tr. 51. This is consistent
with the ALJ’s characterization of Stitzlein’s testimony. Tr. 23.
Stitzlein argues that the ALJ ignored Stitzlein’s “documented issues
with glare and her need to avoid going out at night or being in environments
with bright lights.” Doc. 9, at 14. It is true that in March 2023, Stitzlein told
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her eye doctor that she avoided bright lights and going out at night. Tr. 458.
But at that visit Stitzlein’s eye doctor prescribed new eyeglass lenses to treat
Stitzlein’s 	presbyopia 	(blurriness 	of 	near 	objects) 	and 	hyperopia
(farsightedness). Tr. 461. And at the hearing, the ALJ specifically asked
Stitzlein about her vision while wearing her eyeglasses and Stitzlein did not
mention glare or an inability to go out at night. Tr. 50–51. She only mentioned
that “sometimes … if [she] gets the little spots, the twinkle things [she] can’t
see,” she closed her eyes and sat down “for a little bit.” Tr. 51. Moreover, the
ALJ observed that Stitzlein testified that she drove a vehicle and had no
driving restrictions.7 Tr. 24.
Stitzlein complains that the ALJ “failed to discuss any of the objective
findings contained in [Stitzlein’s eye doctor’s notes], findings which confirm
map dot fingerprint changes on the cornea, scattered vacuole of the lens
bilaterally, and presbyopia and hyperopia (loss of near vision).” Doc. 9, at 14
(citing Tr. 460–61). But Stitzlein’s presbyopia and hyperopia were treated with
corrective lenses, Tr. 461, as the ALJ noted, Tr. 26, and the fact that Stitzlein’s
exam 	showed 	findings 	consistent 	with 	Fuchs’ 	corneal 	dystrophy 	doesn’t
7 	In her reply brief, Stitzlein cites a function report she completed in April
2023, in which she stated that she drives “a little bit, but she was just
diagnosed with lupus so her eyes have gotten a little bad, so most of the time
she requires her husband or daughters to drive her.” Doc. 12, at 1 (citing Tr.
405). But Stitzlein does not dispute that at the April 2024 administrative
hearing she testified that she “normally” drove herself and had no driving
restrictions. Tr. 44.
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indicate what limitations would result due to this condition.8 See Higgs v.
Bowen, 880 F.2d 860, 863 (6th Cir. 1988) (“The mere diagnosis of [a condition]
… says nothing about the severity of the condition.”); Baker v. Colvin, No. 1:15-
cv-910, 2016 WL 4128435, at *13 (N.D. Ohio Aug. 3, 2016) (“a diagnosis alone
does not establish that a condition is disabling, nor does it establish the extent,
if any, of the functional limitations caused by the condition.”). Stitzlein has not
shown that the ALJ’s finding that there was a “lack of evidence of significant
visual acuity or field limitations which are not addressed by corrective lenses,”
was unsupported.
Moreover, the ALJ commented that Stitzlein’s treatment for Fuchs’
corneal dystrophy was conservative, “consisting of prescribed lenses, with no
indication of visual acuity or field limitations.” Tr. 25; see Tr. 461 (Eye doctor’s
note prescribing Stitzlein corrective lenses, indicating that she should call if
there were any changes and otherwise follow up with a yearly exam). Stitzlein
claims that the ALJ’s characterization of her treatment as “conservative” was
“inappropriate” because Fuchs’ corneal dystrophy “is a disease with ‘no cure’
and until it has progressed to the point of necessitating a corneal transplant,
conservative treatment of symptoms and monitoring of progression is all that
8 	Stitzlein 	cites 	a 	website 	that 	describes 	what 	map-dot-fingerprint
dystrophy is, Doc. 9, at 14 n.1, but this is a different condition than what
Stitzlein was diagnosed with, which was Fuchs’ cornea dystrophy, Tr. 460–61.
See 	https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-
diseases/corneal-conditions/corneal-dystrophies 	[https://perma.cc/RM2N-
AHVL] (describing different corneal conditions).
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is medically indicated.” Doc. 9, at 15 (citing https://www.lei.org.au/services/eye-
health-information/fuchs-dystrophy/). But it is not for this Court to assess
medical evidence or literature in the first instance. And, in any event, the
website that Stitzlein sites in support states that “[i]n early stage Fuchs’
dystrophy the condition is usually monitored,” and “later, when the cornea
begins to swell and blur the vision all the time, then a corneal transplant may
be 	considered.” 	See 	https://www.lei.org.au/services/eye-health-
information/fuchs-dystrophy/ 	[https://perma.cc/47Q9-2UVL]. 	This 	does 	not
show that the ALJ’s characterization of Stitzlein’s treatment as conservative
was “inappropriate.” Instead, it supports a finding that Stitzlein’s condition
was in the early, monitoring stages.
Stitzlein argues that the ALJ failed to explain how avoiding hazards is
an “accommodation” for Stitzlein’s eye condition. Doc. 9, at 15. But the ALJ’s
hazard restriction flows naturally from Stitzlein’s eye condition; it did not
require further explanation. See, e.g., Walker v. Comm’r of Soc. Sec., No. 1:21-
cv-1474, 2022 WL 2612244, at *11 (N.D. Ohio May 17, 2022) (finding that the
ALJ’s RFC accommodated the claimant’s one-eye blindness “by avoiding
exposure to hazards, driving, and jobs that require depth perception”), report
and recommendation adopted, 2022 WL 4479922 (N.D. Ohio Sept. 27, 2022).
Indeed, Stitzlein does not identify a restriction that she believes the ALJ
should have assessed.
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Meanwhile, no medical provider assessed any vision restrictions; the
consultative examiner in December 2022 found that Stitzlein’s eyesight was
20/25. In her reply brief, Stitzlein points out that the state agency reviewers
did not find her Fuchs’ corneal dystrophy to be a severe impairment and thus
did not assess limitations for it. Doc. 12, at 2. She submits that “without the
benefit of any medical expertise or guidance, the ALJ appears to have simply
guessed as to the impact of [Stitzlein’s] severe visual impairments.” Doc. 9, at
16. But the Sixth Circuit “ha[s] previously rejected the argument that a
residual functional capacity determination cannot be supported by substantial
evidence unless a physician offers an opinion consistent with that of the ALJ.”
Mokbel-Aljahmi v. Comm’r of Soc. Sec., 732 F. App’x 395, 401 (6th Cir. 2018).
Stitzlein complains that the ALJ’s RFC assessment that Stitzlein avoid
hazards was “not a new limitation” because “[i]t was previously made for
purposes 	of 	[Stitzlein’s] 	lumbar 	disc 	disease 	of 	the 	lumbar 	spine 	and
fibromyalgia.” Doc. 12, at 2. But Stitzlein doesn’t cite legal authority stating
that an ALJ is forbidden from using a limitation to cover multiple conditions.
In short, the ALJ at step two found Stitzlein’s Fuchs’ cornea dystrophy
to be a severe impairment, Tr. 20; accounted for this condition in her RFC
assessment, Tr. 26; and explained why she did not find Stitzlein to be more
limited, Tr 26. Stitzlein has not shown that the ALJ erred or that her decision
is unsupported by substantial evidence.
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2. The ALJ did not err when evaluating Stitzlein’s reports of symptoms
Stitzlein argues that the ALJ failed to evaluate Stitzlein’s allegations in
accordance with Social Security Ruling 16-3p. Doc. 9, at 17.
To 	evaluate the “intensity, 	persistence, and limiting effects 	of 	an
individual’s symptoms,” the ALJ considers medical evidence, the claimant’s
statements, other information provided by medical sources, and any other
relevant evidence in the record. See Soc. Sec. Ruling 16-3p, 2017 WL 5180304,
at *4 (Oct. 25, 2017); 20 C.F.R. § 404.1529. Other relevant evidence includes:
daily activities; the location, duration, frequency, and intensity of pain or
symptoms; 	precipitating 	and 	aggravating 	factors; 	the 	type, 	dosage,
effectiveness, 	and 	side 	effects 	of 	any 	medication; 	treatment, 	other 	than
medication, to relieve pain; any measures used to relieve pain; and “[o]ther
factors concerning … functional limitations and restrictions due to pain or
other symptoms.” 20 C.F.R. § 404.1529(c). “The ALJ need not analyze all seven
factors, but should show that he considered the relevant evidence.” Hatcher v.
Berryhill, No. 1:18-cv-1123, 2019 WL 1382288, at *15 (N.D. Ohio Mar. 27,
2019) (citing Cross v. Comm’r of Soc. Sec., 373 F. Supp. 2d 724, 733 (N.D. Ohio
2005)).
Stitzlein first argues that the “ALJ applied an incorrect standard by
evaluating whether [Stitzlein’s] allegations were entirely consistent with the
evidence of record rather [than] the standard set forth in the regulations, i.e.,
whether plaintiff’s allegations can reasonably be accepted as consistent with
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the evidence of record.” Doc. 9, at 17 (emphasis added, internal quotation
marks omitted) (citing Deville v. Comm’r of Soc. Sec., No. 1:23-cv-578, 2024 WL
4249128, at *6 (W.D. Mich. Sept. 20, 2024), and Soc. Sec. Ruling 16-3p). The
fact that the ALJ stated the oft-quoted conclusion that Stitzlein’s statements
were “not entirely consistent with” the record evidence, Tr. 25, does not mean
that the ALJ applied an incorrect standard. It simply means that the ALJ
found Stitzlein’s statements to be inconsistent with the record, which is what
the regulations require. See Soc. Sec. Ruling 16-3p, 2017 WL 5180304, at *2
(“[W]e consider all of the individual’s symptoms, … and the extent to which the
symptoms can reasonably be accepted as consistent with the objective medical
and other evidence in the individual’s record.”). Moreover, in Deville, the court
relied on its conclusion in another case, Mogdis v. Comm’r of Soc. Sec., No.
1:18-cv-82, 2019 WL 652571, at *4 (W.D. Mich. Feb. 14, 2019), which held that
the ALJ’s use of the words “not entirely consistent” indicated that the ALJ
applied the wrong standard. See Deville, 2024 WL 4249128, at *6. But “Mogdis
is an outlier.” Kim W. v. Comm’r of Soc. Sec., No. 2:24-cv-12648, 2025 WL
3118954, at *10 (E.D. Mich. Oct. 3, 2025), report and recommendation adopted,
No. 24-cv-12648, 2025 WL 3113622 (E.D. Mich. Nov. 6, 2025). Indeed, “the
Sixth Circuit has regularly affirmed decisions where the ALJ used the exact
[not entirely consistent] language that was used in both Mogdis and this case.”
Id. (citing cases).
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As for the substance of the ALJ’s decision, the ALJ explained why she
discounted Stitzlein’s statements about her physical limitations as follows:
Regarding the claimant’s physical impairments, the
record reflects a history of degenerative disc disease
of 	the 	lumbar 	spine, 	fibromyalgia, 	and 	Fuchs’
corneal dystrophy. At no time during the period at
issue did the claimant require inpatient treatment
or invasive interventions for any of the claimant’s
alleged 	impairments 	with 	wholly 	conservative
treatment noted throughout the period at issue.
Physical examination findings did not support the
extent 	of 	limitation 	alleged 	during 	testimony,
consisting 	primarily 	of 	intermittent 	joint
tenderness. However, there is no support in the
record for the extent of the claimant’s alleged lifting
restriction nor the claimant’s sitting, standing, and
walking abilities as reported during testimony. With
respect to the claimant’s visual allegations, again
treatment 	was 	wholly 	conservative 	consisting 	of
prescribed lenses, with no indication of visual acuity
or field limitations. As for the claimant’s alleged
fibromyalgia, rheumatology notes reflected orders
for additional evaluative testing, but no indication
that 	the 	testing 	was 	obtained. 	Therefore, 	the
undersigned 	having 	considered 	the 	claimant’s
subjective reports evaluated against the treatment
evidence 	of 	record, 	finds 	the 	claimant 	able 	to
perform 	[reduced] 	light 	work 	with 	[additional
limitations].
Tr. 25.
Stitzlein contends that the ALJ only cited Stitzlein’s physical exam
findings, Doc. 9, at 18, Doc. 12, at 4, but the ALJ also cited Stitzlein’s
conservative treatment and failure to follow up with testing, Tr. 25, see 20
C.F.R. § 404.1529(c)(3)(iv),(v) (the ALJ considering the claimant’s treatment).
The ALJ also explained that she limited Stitzlein to occasional climbing, rather
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than the frequent climbing that the state agency reviewers had assessed, “in
consideration of [Stitzlein’s] subjective reports during testimony.” Tr. 26, 48.
And the ALJ adopted the consultative examiner’s findings that Stitzlein could
stand and walk for four, rather than six, hours in an eight-hour workday. Tr.
26; see 20 C.F.R. § 404.1529(c)(1) (the ALJ considers medical opinion evidence).
Stitzlein contends that her “severe fibromyalgia is of such a nature that
it does not lend itself to objective observation other than the joint tenderness
the ALJ concedes is documented in the record.” Doc. 9, at 19. But the ALJ
observed that Stitzlein failed to follow through with further evaluations, Tr.
25, which is an appropriate reason to discount Stitzlein’s reports of symptom
severity. See, e.g., Blacha v. Sec’y of Health & Hum. Servs., 927 F.2d 228, 231
(6th Cir. 1990) (claimant’s failure to seek treatment undercut complaints of
disabling symptoms). Moreover, “[u]nder [the] regulations, an individual’s
statements of symptoms alone are not enough to establish the existence of a
physical or mental impairment or disability.” Soc. Sec. Ruling 16-3p, 2017 WL
5180304, at *2.
Stitzlein has not shown that the ALJ erred when evaluating her reports
of symptoms.
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Conclusion
For the reasons explained above, I recommend that the Court affirm the
Commissioner’s decision.
Dated: December 10, 2025
/s/ James E. Grimes Jr.
James E. Grimes Jr.
U.S. Magistrate Judge
OBJECTIONS
Any objections to this Report and Recommendation must be filed with
the Clerk of Court within 14 days after the party objecting has been served
with a copy of this Report and Recommendation. 28 U.S.C. § 636(b)(1). Failure
to file objections within the specified time may forfeit the right to appeal the
District Court’s order. See Berkshire v. Beauvais, 928 F.3d 520, 530–31 (6th
Cir. 2019).
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