Case Name in Social Security Case - Unavailable

IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF PENNSYLVANIA
HELEN WHITE, 	: Civil No. 1:24-CV-1900
:
Plaintiff, 	:
:
v. 	:
: (Chief Magistrate Judge Bloom)
FRANK BISIGNANO, 	:
Commissioner of Social Security,1 	:
:
Defendant. 	:
MEMORANDUM OPINION
I. 	Introduction
Helen White filed an application under Titles II and XVI of the
Social Security Act for disability and disability insurance benefits and
supplemental security income on February 1, 2022. Following a hearing
before an Administrative Law Judge (“ALJ”), the ALJ found that White
was not disabled from her alleged onset date of December 31, 2020,
through January 31, 2024, the date of the ALJ’s decision.
1 	Frank 	Bisignano 	became 	the 	Commissioner 	of 	Social 	Security 	on
May 7, 2025. Pursuant to Rule 25(d) of the Federal Rules of Civil
Procedure 	and 	42 	U.S.C. 	§ 	405(g), 	Bisignano 	is 	substituted 	as 	the
defendant in this suit.
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White now appeals this decision, arguing that the ALJ’s decision is
not supported by substantial evidence. After a review of the record, and
mindful of the fact that substantial evidence “means only—‘such relevant
evidence as a reasonable mind might accept as adequate to support a
conclusion,’” 2 we conclude that substantial evidence supports the ALJ’s
findings in this case. 	Therefore, we will affirm the decision of the
Commissioner denying this claim.
II. 	Statement of Facts and of the Case
Helen White filed for disability and disability insurance benefits, as
well as supplemental security income, alleging disability due to moderate
spinal stenosis, scoliosis, bulging and herniated discs in the lower back,
degenerative disc disease, arthritis, type 2 diabetes, high cholesterol, and
high blood pressure.3 	White was 60 years old at the time of her alleged
onset of disability and had past relevant work as a kitchen supervisor. 4
The medical record regarding White’s impairments revealed that
White treated for persistent lower back and extremity pain prior to the
2
Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019).
3 Tr. 67.
4 Tr. 26, 67.
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alleged disability period. 	Thus, in September of 2020, at a visit to
Lebanon Valley Family Medicine for a diabetes follow up, Dr. Mark
Leach, M.D., noted White’s persistent back pain radiating to her legs. 5
White reported that her legs felt like they would give out at times, and
that her pain was worse with prolonged standing and walking. 6 	Dr.
Leach noted that White was taking narcotic pain medications and had
received epidural shots with no relief.7 She was advised to continue with
the pain clinic for pain management. 8
White was seen at the Lebanon Pain Relief Center in November, at
which time she reported taking more Percocet due to increased lower
back and leg pain. 9 	Notes from this visit detail White’s history of
treatment for her chronic pain, including a lumbar spine MRI from 2017
showing moderate to severe spinal stenosis, a 2017 lumbar spine x-ray
showing moderate right scoliosis and marked degenerative changes at all
5 Tr. 400-01.
6 Tr. 400.
7 Tr. 400-01.
8 Tr. 403.
9 Tr. 578.
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levels, and that White received injections for her pain in 2017 and 2018. 10
A physical examination revealed that White walked with an antalgic gait
with a cane and had moderately reduced range of motion in her lumbar
spine.11 	In December, White reported she had missed a lot of work and
had resigned.12
Treatment notes from the Pain Relief Center in February of 2021
indicate that White reported increased pain, which was aggravated by
daily activities, bending, lifting, sitting, standing, and walking.13 	A
physical 	examination 	revealed 	an 	antalgic 	gait 	with 	a 	cane 	and
moderately 	reduced 	range 	of 	motion, 	as 	well 	as 	normal 	balance,
coordination, and fine motor skills. 14 	Dr. Daniel Lorenzo filled White’s
medications, and she was advised to follow up in one month. 15 In March,
White 	reported 	that 	while 	the 	Butrans 	patch 	she 	was 	using 	was
providing some relief, and she was taking fewer Percocet since starting
10 Tr. 578-79.
11 Tr. 582.
12 Tr. 571.
13 Tr. 564.
14 Tr. 568-69.
15 Tr. 569.
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the patch, she could no longer afford it.16 	Dr. Lorenzo prescribed her a
fentanyl 	patch. 17 	White 	reported 	in 	June 	that 	the 	fentanyl 	patch
provided good pain relief, and the side effects she initially had were
resolved. 18 	White made a similar report to Dr. Lorenzo in September, at
which time a physical examination revealed an antalgic gait with a cane,
tenderness of the lumbar spine, and normal balance, coordination, and
fine motor skills. 19
In November, treatment notes from the Pain Relief Center indicate
that White’s pain level was a four, and that her pain was fluctuating and
intermittent. 20 She took Percocet only for exacerbations, which provided
some relief.21 	White reported experiencing increased pain for a week in
December, but she was still getting good relief from the fentanyl patch.22
A physical examination was similar to her prior visits, indicating an
antalgic gait with a cane and moderate pain with range of motion, but
16 Tr. 557.
17 Tr. 562.
18 Tr. 543.
19 Tr. 520, 524-25
20 Tr. 514.
21
Id.
22 Tr. 499.
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normal balance, coordination, and fine motor skills. 23 	Treatment notes
from her family doctor around this time indicate that White injured her
foot when she hit her recliner.24 	An x-ray showed a traumatic fracture,
and White was prescribed a walker to help maintain her self-sufficiency
and daily activities. 25 	Dr. Lorenzo noted in January of 2022 that White
was wearing a boot after fracturing her foot, but that her lower back pain
symptoms were about the same. 26
White underwent an x-ray of her right knee in March of 2022, which
showed tricompartmental osteoarthritis. 27 	White was diagnosed with
primary 	osteoarthritis 	of 	the 	right 	knee 	in 	April 	and 	underwent
injections. 28 	An examination at this time revealed an antalgic gait with
a cane, no tenderness, and normal sensation to light touch. 29 Around this
time, White followed up with the Pain Relief Center, where it was noted
23 Tr. 504.
24 Tr. 385.
25 Tr. 365-66, 387.
26 Tr. 489.
27 Tr. 364.
28 Tr. 432, 435.
29 Tr. 434.
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she experienced partial relief from the knee injection.30 	Her back pain
was noted to be at a severity level of eight, and a physical examination
was similar to prior examinations, showing an antalgic gait, moderate
pain with range of motion, and normal balance, coordination, and fine
motor skills. 31 In May, White reported that her knee pain was back to its
baseline, and her back pain was a severity level of five.32
White received injections in her knee between July and September
of 2022.33 	In August, White reported to her family doctor that she was
experiencing leg aches and swelling.34 	Dr. Leach advised her to elevate
her legs and watch her salt intake. 35 	In September, White advised that
she 	had 	not 	experienced 	much 	improvement 	in 	her 	pain 	from 	the
injections. 36 	At a visit to the Pain Relief Center in October, White
reported increased pain and swelling in her lower extremities.37 	It was
30 Tr. 457.
31 Tr. 457, 462.
32 Tr. 450.
33 Tr. 801-09.
34 Tr. 691-92.
35 Tr. 692.
36 Tr. 670.
37 Tr. 715.
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noted that an increase in Gabapentin helped with her leg spasms and
cramps. 38 	A physical examination revealed an antalgic gait with a cane,
mild pain with range of motion, and normal balance, coordination, and
fine 	motor 	skills. 39 	Treatment 	notes 	from 	a 	November 	2022 	visit
contained largely identical findings, but in January of 2023, White
reported increased pain.40
In March of 2023, White underwent surgery for carpal tunnel
syndrome in her right hand. 41 	Prior to surgery, she reported difficulty
with everyday tasks, such as opening a water bottle.42 	At her two-week
post operative appointment in April, White reported numbness and
tingling in her right hand but noted improvement in strength, pain, and
sensation. 43 	Around this time, White also underwent another injection
for her knee pain. 44 In May, treatment notes from the Pain Relief Center
indicate 	that 	White 	was 	receiving 	adequate 	relief 	from 	her 	pain
38
Id.
39 Tr. 720.
40 Tr. 707-13, 846.
41 Tr. 795.
42 Tr. 798.
43 Tr. 788.
44 Tr. 784.
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medications, although her back pain was persistent but fluctuating. 45 	A
physical examination revealed an antalgic gait with a cane, facet joint
loading, and moderate pain with range of motion.46 	White reported
increased pain to Dr. Lorenzo in July of 2023, at which time he discussed
the possibility of trying CBD oil. 47
White continued to treat at the Pain Relief Center throughout 2023.
Treatment notes from October to December indicate that White’s pain
was persistent but stable, she was receiving adequate relief from her
medications, and she had no new concerns. 48 Examinations in November
and December revealed positive face joint loading, positive straight leg
raise testing, and no edema.49 	White also continued to receive knee
injections around this time. 50 	Additionally, throughout the relevant
period, White’s body mass index (“BMI”) was indicative of obesity. 51
45 Tr. 817.
46 Tr. 821.
47 Tr. 934, 938.
48 Tr. 927, 965, 1174.
49 Tr. 970, 1179.
50 Tr. 1200-04.
51
See e.g., Tr. 382, 397, 873, 1217.
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It is against the backdrop of this record that an ALJ held a hearing
on White’s disability application on January 9, 2024.52 	White and a
Vocational 	Expert 	both 	appeared 	and 	testified 	at 	this 	hearing. 53
Following this hearing, on January 31, 2024, the ALJ issued a decision
denying White’s application for disability benefits. 54 	The ALJ first
concluded that White had not engaged in substantial gainful activity
since her alleged onset date of December 31, 2020.55 	At Step 2 of the
sequential analysis that governs disability claims, the ALJ found that
White suffered from severe impairments of lumbar degenerative disc
disease, right carpal tunnel syndrome, and right knee osteoarthritis. 56
The ALJ found White’s obesity to be nonsevere, and noted that there was
little evidence to suggest that her obesity more than minimally affected
her abilities or contributed to the effects of her other impairments. 57 	At
Step 3, the ALJ concluded that none of these impairments met or equaled
52 Tr. 34-60.
53
Id.
54 Tr. 15-33.
55 Tr. 21.
56
Id.
57 Tr. 21-22.
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the 	severity 	of 	a 	listed 	impairment 	under 	the 	Commissioner’s
regulations. 58
Between Steps 3 and 4, the ALJ then concluded that White:
[H]a[d] the residual functional capacity to perform light work
as defined in 20 CFR 404.1567(b) and 416.967(b) except the
claimant can lift and carry no more than 10 pounds on either
a frequent or occasional basis. The claimant can sit 6 hours,
stand 2 hours, and walk 2 hours during an 8-hour workday;
can occasionally perform postural activities except that the
claimant can never climb ladders/ropes/scaffolds, kneel, or
crouch; can never push or pull with the right lower extremity;
can 	frequently 	handle 	and 	finger 	with 	the 	right 	upper
extremity; 	and 	can 	tolerate 	no 	concentrated 	exposure 	to
extreme heat, vibration, unprotected heights, and moving
machinery parts. 59
In 	reaching 	this 	RFC 	determination, 	the 	ALJ 	considered 	the
objective medical record detailed above, the medical opinion evidence,
and White’s reported symptoms. 	With respect to the medical opinion
evidence, the ALJ considered the opinions of state agency consultants,
Drs. Sasnauskas and Deleo, and found these opinions persuasive. 60
These opinions found that White could perform a range of sedentary work
58 Tr. 22.
59 Tr. 23.
60 Tr. 25-26.
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with some additional postural limitations. 61 	The ALJ reasoned that
these opinions were generally consistent with White’s allegations and
with the treatment records reviewed by these physicians.62 However, the
ALJ accounted for a more restrictive limitation as it related to White’s
right lower extremity. 63 	He also increased White’s capacity to stand and
walk from 2 hours total to 2 hours each occasion due to White’s later-
reported response to her pain medications. 64
With respect to White’s symptoms, the ALJ found that White’s
statements concerning the intensity, persistence, and limiting effects of
her 	impairments 	were 	not 	entirely 	consistent 	with 	the 	medical
evidence. 65 	White testified that her diabetes, cholesterol, and blood
pressure were managed well with medication.66 She reported lower back
pain that radiated into her legs, and that she used a cane to help her
walk. 67 	She 	further 	testified 	that 	she 	was 	able 	to 	perform 	some
61 Tr. 69-71, 86-89.
62 Tr. 26.
63
Id.
64
Id.
65 Tr. 23-25.
66 Tr. 39.
67 Tr. 40.
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household chores with breaks, but that she needed help to grocery shop. 68
White stated that she could not sit, stand, or walk for long periods of time
due to pain, but that her pain medications helped her symptoms.69
The ALJ ultimately found White’s testimony to be inconsistent with
the objective clinical findings.70 The ALJ recounted the objective medical
evidence, including the abnormal findings of an antalgic gait and reduced
range of motion and unremarkable findings of normal balance, sensation,
coordination, and motor skills. 71 	He further recognized that White’s
treatment records and testimony indicated her pain was managed with
medications. 72 	Ultimately, the ALJ concluded that White was not as
limited as she alleged.
Having made these findings, the ALJ found at Step 4 that White
could perform her past work as a kitchen supervisor. 73 	Accordingly, the
68 Tr. 46-47.
69 Tr. 51-53.
70 Tr. 23-25.
71 Tr. 23.
72
Id.
73 Tr. 26-27.
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ALJ found that White had not met the stringent standard prescribed for
disability benefits and denied her claim. 74
This appeal followed. 	On appeal, White argues that the ALJ’s
decision is not supported by substantial evidence because he failed to
account for White’s use of a cane, address her obesity, and adequately
develop the record. 	This case is fully briefed and is therefore ripe for
resolution. For the reasons set forth below, we will affirm the decision of
the Commissioner.
III. 	Discussion
A. Substantial Evidence Review – the Role of this Court
This Court’s review of the Commissioner’s decision to deny benefits
is limited to the question of whether the findings of the final decision-
maker are supported by substantial evidence in the record.75 	Substantial
evidence “does not mean a large or considerable amount of evidence, but
rather such relevant evidence as a reasonable mind might accept as
74 Tr. 27.
75
See 42 U.S.C. §405(g);
Johnson v. Comm’r of Soc. Sec., 529 F.3d 198,
200 (3d Cir. 2008);
Ficca v. Astrue, 901 F. Supp. 2d 533, 536 (M.D. Pa.
2012).
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adequate to support a conclusion.” 76 	Substantial evidence means less
than a preponderance of the evidence but more than a mere scintilla.77
A single piece of evidence is not substantial evidence if the ALJ
“ignores, 	or 	fails 	to 	resolve, 	a 	conflict 	created 	by 	countervailing
evidence.”78 	However, where there has been an adequately developed
factual record, substantial evidence may be “something less than the
weight of the evidence, and the possibility of drawing two inconsistent
conclusions from the evidence does not prevent [the ALJ’s decision] from
being supported by substantial evidence.” 79 	The court must “scrutinize
the record as a whole” to determine if the decision is supported by
substantial evidence. 80
The Supreme Court has explained the limited scope of our review,
noting 	that 	“[substantial 	evidence] 	means—and 	means 	only—‘such
relevant evidence as a reasonable mind might accept as adequate to
76
Pierce v. Underwood, 487 U.S. 552, 565 (1988).
77
Richardson v. Perales, 402 U.S. 389, 401 (1971).
78
Mason v. Shalala, 994 F.2d 1058, 1064 (3d Cir. 1993) (quoting
Kent v.
Schweiker, 	710 	F.2d 	110, 	114 	(3d 	Cir. 	1983)) 	(internal 	quotations
omitted).
79
Consolo v. Fed. Maritime Comm’n, 383 U.S. 607, 620 (1966).
80
Leslie v. Barnhart, 304 F. Supp.2d 623, 627 (M.D. Pa. 2003).
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support a conclusion.’”81 	Under this standard, we must look to the
existing 	administrative 	record 	to 	determine 	if 	there 	is 	“‘sufficient
evidence’ to support the agency’s factual determinations.”82 	Thus, the
question before us is not whether the claimant is disabled, but rather
whether the Commissioner’s finding that he or she is not disabled is
supported 	by 	substantial 	evidence 	and 	was 	based 	upon 	a 	correct
application of the law. 83
When conducting this review, we must remain mindful that “we
must not substitute our own judgment for that of the fact finder.” 84 Thus,
we cannot re-weigh the evidence. Instead, we must determine whether
81
Biestek, 139 S. Ct. at 1154 (quoting
Consolidated Edison Co. v. NLRB,
305 U.S. 197, 229 (1938)).
82
Id.
83
See Arnold v. Colvin, No. 3:12-CV-02417, 2014 WL 940205, at *1 (M.D.
Pa. Mar. 11, 2014) (“[I]t has been held that an ALJ’s errors of law denote
a 	lack 	of 	substantial 	evidence”) 	(alterations 	omitted);
	Burton 	v.
Schweiker, 512 F. Supp. 913, 914 (W.D. Pa. 1981) (“The Secretary’s
determination as to the status of a claim requires the correct application
of the law to the facts”);
see also Wright v. Sullivan, 900 F.2d 675, 678
(3d Cir. 1990) (noting that the scope of review on legal matters is
plenary);
Ficca, 901 F. Supp. 2d at 536 (“[T]he court has plenary review
of all legal issues . . . .”).
84
Zirnsak v. Colvin, 777 F.3d 607, 611 (3d Cir. 2014) (citing
Rutherford
v. Barnhart, 399 F.3d 546, 552 (3d Cir. 2005)).
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there is substantial evidence to support the ALJ’s findings. 	In doing so,
we must also determine whether the ALJ’s decision meets the burden of
articulation necessary to enable judicial review; that is, the ALJ must
articulate the reasons for his decision.85 	This does not require the ALJ
to use “magic” words, but rather the ALJ must discuss the evidence and
explain the reasoning behind his or her decision with more than just
conclusory 	statements. 86 	Ultimately, 	the 	ALJ’s 	decision 	must 	be
accompanied by “a clear and satisfactory explication of the basis on which
it rests.” 87
B. Initial Burdens of Proof, Persuasion, and Articulation for the ALJ
To receive disability benefits under the Social Security Act, a
claimant must show that he or she 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
85
Burnett v. Comm’r of Soc. Sec. Admin., 220 F.3d 112, 119 (3d Cir. 2000).
86
See Diaz v. Comm’r of Soc. Sec., 577 F.3d 500, 504 (3d Cir. 2009)
(citations omitted).
87
Cotter v. Harris, 642 F.2d 700, 704 (3d Cir. 1981).
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than 12 months.” 88 This requires a claimant to show a severe physical or
mental impairment that precludes him or her from engaging in previous
work or “any other substantial gainful work which exists in the national
economy.” 89 	To receive benefits under Title II of the Social Security Act,
a claimant must show that he or she is under retirement age, contributed
to the insurance program, and became disabled prior to the date on which
he or she was last insured. 90
In 	making 	this 	determination, 	the 	ALJ 	follows 	a 	five-step
evaluation. 91 	The 	ALJ 	must 	sequentially 	determine 	whether 	the
claimant: (1) is engaged in substantial gainful activity; (2) has a severe
impairment; (3) has a severe impairment that meets or equals a listed
impairment; (4) is able to do his or her past relevant work; and (5) is able
to do any other work, considering 	his or her age, education, work
experience and residual functional capacity (“RFC”).92
88 42 U.S.C. §423(d)(1)(A); 42 U.S.C. §1382c(a)(3)(A);
see also 20 C.F.R.
§§404.1505(a), 416.905(a).
89 	42 	U.S.C. 	§423(d)(2)(A); 	42 	U.S.C. 	§1382c(a)(3)(B); 	20 	C.F.R.
§§404.1505(a), 416.905(a).
90 42 U.S.C. §423(a); 20 C.F.R. §404.131(a).
91 20 C.F.R. §§404.1520(a), 416.920(a).
9220 C.F.R. §§404.1520(a)(4), 416.920(a)(4).
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Between Steps 3 and 4, the ALJ must also determine the claimant’s
residual functional capacity (RFC). 	RFC is defined as “that which an
individual is still able to do despite the limitations caused by his or her
impairment(s).”93 	In making this assessment, the ALJ must consider all
the claimant’s medically determinable impairments, including any non-
severe impairments identified by the ALJ at step two of his or her
analysis. 94 	Our review of the ALJ’s determination of the plaintiff’s RFC
is deferential, and that determination will not be set aside if it is
supported by substantial evidence. 95
The claimant bears the burden at Steps 1 through 4 to show a
medically 	determinable 	impairment 	that 	prevents 	him 	or 	her 	from
engaging in any past relevant work. 96 	If met, the burden then shifts to
the Commissioner to show at Step 5 that there are jobs in significant
numbers 	in 	the 	national 	economy 	that 	the 	claimant 	can 	perform
93
	Burnett, 220 F.3d at 121 (citations omitted);
	see also 20 C.F.R. §
404.1545(a)(1).
94 20 C.F.R. §§404.1545(a)(2), 416.945(a)(2).
95
Burns v. Barnhart, 312 F.3d 113, 129 (3d Cir. 2002).
96
Mason, 994 F.2d at 1064.
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consistent 	with 	the 	claimant’s 	RFC, 	age, 	education, 	and 	work
experience. 97
With 	respect 	to 	the 	RFC 	determination, 	courts 	have 	followed
different paths when considering the impact of medical opinion evidence
on this determination. 	While some courts emphasize the necessity of
medical opinion evidence to craft a claimant’s RFC, other courts have
taken the approach that “[t]here is no legal requirement that a physician
have made the particular findings that an ALJ adopts in the course of
determining an RFC.” 98 	Additionally, in cases that involve no credible
medical opinion evidence, courts have held that “the proposition that an
ALJ must always base his RFC on a medical opinion from a physician is
misguided.” 99
Given these differing approaches, we must evaluate the factual
context 	underlying 	an 	ALJ’s 	decision. 	Cases 	that 	emphasize 	the
importance of medical opinion support for an RFC assessment typically
97 20 C.F.R. §§404.1512(f), 416.912(f);
Mason, 994 F.2d at 1064.
98
Titterington v. Barnhart, 174 F. App’x 6, 11 (3d Cir. 2006);
see also
Biller v. Acting Comm’r of Soc. Sec., 962 F. Supp. 2d 761, 778–79 (W.D.
Pa. 2013).
99
Cummings v. Colvin, 129 F. Supp. 3d 209, 214–15 (W.D. Pa. 2015).
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arise in the factual setting where well-supported medical sources have
found limitations to support a disability claim, but an ALJ has rejected
the medical opinion based upon an assessment of other evidence. 100
These cases simply restate the notion that medical opinions are entitled
to careful consideration when making a disability determination. On the
other hand, when no medical opinion supports a disability finding or
when an ALJ relies upon other evidence to fashion an RFC, courts have
routinely sustained the ALJ’s exercise of independent judgment based
upon all the facts and evidence.101 	Ultimately, it is our task to
determine, 	considering 	the 	entire 	record, 	whether 	the 	RFC
determination is supported by substantial evidence. 102
C. Legal Benchmarks for the ALJ’s Assessment of Medical Opinions
For applications filed after March of 2017, the regulations require
ALJs to consider several factors to determine the persuasiveness of a
medical 	opinion: 	supportability, 	consistency, 	relationship 	with 	the
100
Biller, 962 F. Supp. 2d at 778–79.
101
See Titterington, 174 F. App’x 6;
Cummings, 129 F. Supp. 3d at 214–
15.
102
Burns, 312 F.3d 113.
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claimant, 	specialization, 	and 	other 	factors 	tending 	to 	support 	or
contradict a medical opinion. 103 	Supportability and consistency are the
two most important factors, and an ALJ must explain how these factors
were considered in his or her written decision. 104 	Supportability means
“[t]he 	more 	relevant 	the 	objective 	medical 	evidence 	and 	supporting
explanations . . . are to support his or her medical opinion(s) . . . . the
more persuasive the medical opinions . . . will be.”105 	The consistency
factor focuses on how consistent the opinion is “with the evidence from
other medical sources and nonmedical sources.”106
While there is an undeniable medical aspect to the evaluation of
medical opinions, it is well settled that “[t]he ALJ – not treating or
examining physicians or State agency consultants – must make the
ultimate disability and RFC determinations.” 107 	When confronted with
several medical opinions, the ALJ can choose to credit certain opinions
103 20 C.F.R. § 404.1520c(c).
104 20 C.F.R. §§ 404.1520c(b)(2), 416.920c(b)(2);
Blackman v. Kijakazi,
615 F. Supp. 3d 308, 316 (E.D. Pa. 2022).
105 20 C.F.R. §§ 404.1520c(c)(1), 416.920c(c)(1).
106 20 C.F.R. §§ 404.1520c(c)(2), 416.920c(c)(2).
107
Chandler v. Comm’r of Soc. Sec., 667 F.3d 356, 361 (3d Cir. 2011).
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over others but “cannot reject evidence for no reason or for the wrong
reason.” 108 Further, the ALJ can credit parts of an opinion without giving
credit to the whole opinion and may formulate a claimant’s RFC based
on different parts of different medical opinions, so long as the rationale
behind the decision is adequately articulated. 109 	On the other hand, in
cases 	where 	no 	medical 	opinion 	credibly 	supports 	the 	claimant’s
allegations, “the proposition that an ALJ must always base his RFC on a
medical opinion from a physician is misguided.” 110
D. Legal 	Benchmarks 	for 	the 	ALJ’s 	Assessment 	of 	a 	Claimant’s
Alleged Symptoms
When evaluating lay testimony regarding a claimant’s reported
degree 	of 	pain 	and 	disability, 	the 	ALJ 	must 	make 	credibility
determinations. 111 	Our review of those determinations is deferential. 112
However, it is incumbent upon the ALJ to “specifically identify and
explain what evidence he found not credible and why he found it not
108
Mason, 994 F.2d at 1066.
109
See Durden v. Colvin, 191 F. Supp. 3d 429, 455 (M.D. Pa. 2016).
110
Cummings, 129 F. Supp. 3d at 214–15.
111
See Diaz v. Comm’r, 577 F.3d 500, 506 (3d Cir. 2009).
112
Id.
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credible.” 113 	An ALJ should give great weight to a claimant’s testimony
“only when it is supported by competent medical evidence.” 114 	As the
Third Circuit has noted, while “statements of the individual concerning
his or her symptoms must be carefully considered, the ALJ is not required
to credit them.”115
The Social Security Rulings and Regulations provide a framework
for evaluating the severity of a claimant’s reported symptoms.116 	Thus,
the ALJ must follow a two-step process: first, the ALJ must determine
whether a medically determinable impairment could cause the symptoms
alleged; 	and 	second, 	the 	ALJ 	must 	evaluate 	the 	alleged 	symptoms
considering the entire administrative record.117
Symptoms such as pain or fatigue will be considered to affect a
claimant’s ability to perform work activities only if medical signs or
113
Zirnsak v. Colvin, 777 F.3d 607, 612 (3d Cir. 2014) (citations omitted).
114
	McKean v. Colvin, 150 F. Supp. 3d 406, 415–16 (M.D. Pa. 2015)
(citations omitted).
115
Chandler v. Comm’r of Soc. Sec., 667 F.3d 356, 363 (3d. Cir. 2011)
(referencing 20 C.F.R. §404.1529(a) (“statements about your pain or other
symptoms will not alone establish that you are disabled”).
116 20 C.F.R. §§ 404.1529, 416.929; SSR 16–3p.
117 SSR 16-3p.
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laboratory findings establish the presence of a medically determinable
impairment that could reasonably be expected to produce the alleged
symptoms. 118 	During the second step of this assessment, the ALJ must
determine whether the claimant’s statements regarding the intensity,
persistence, or limiting effects of his or her symptoms are substantiated
considering the entire case record. 119 This includes, but is not limited to,
medical 	signs 	and 	laboratory 	findings; 	diagnoses; 	medical 	opinions
provided by treating or examining sources and other medical sources; and
information regarding the claimant’s symptoms and how they affect his
or her ability to work. 120
The Social Security Administration recognizes that individuals
may be limited by their symptoms to a greater or lesser extent than other
individuals with the same medical impairments, signs, and laboratory
findings. 121 	Thus, to assist in the evaluation of a claimant’s subjective
symptoms, the Social Security Regulations set forth seven factors that
118 20 C.F.R. §§ 404.1529(b), 416.929(b); SSR 16–3p.
119 20 C.F.R. § 404.1529(c), 416.929(c); SSR 16–3p.
120
Id.
121 SSR 16-3p.
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may be relevant to the assessment of the claimant’s alleged symptoms. 122
These 	factors 	include: 	the 	claimant’s 	daily 	activities; 	the 	“location,
duration, frequency, and intensity” of the claimant’s pain or symptoms;
the type, dosage, and effectiveness of medications; treatment other than
medications; 	and 	other 	factors 	regarding 	the 	claimant’s 	functional
limitations. 123
E. The ALJ’s Decision is Supported by Substantial Evidence.
Our review of the ALJ’s decision denying an application for benefits
is significantly deferential. Our task is simply to determine whether the
ALJ’s decision is supported by substantial evidence in the record; that is
“only— ‘such relevant evidence as a reasonable mind might accept as
adequate to support a conclusion.’”124 	Judged against this deferential
standard of review, we conclude that substantial evidence supported the
ALJ’s decision in this case.
White first argues that the ALJ erred in failing to account for her
use of a cane in the RFC or in the hypothetical to the vocational expert.
122 20 C.F.R. §§ 404.1529(c)(3), 416.929(c)(3).
123
Id.
124
Biestek, 139 S. Ct. at 1154.
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In 	some 	cases, 	the 	claimant’s 	use 	of 	a 	cane 	may 	be 	outcome-
determinative. 	However, the burden lies with the claimant initially to
show 	that 	the 	cane 	is 	medically 	required 	by 	providing 	“medical
documentation establishing the need for a hand-held assistive device to
aid in walking or standing, and describing the circumstances for which it
is needed[.]”125 	If the claimant demonstrates such a medical necessity,
then the ALJ must directly “address the evidence concerning Plaintiff's
use of” an assistive device.126 	The failure to do so may require a
remand. 127 	Additionally, when the evidence demonstrates the medical
necessity of the assistive device, and a vocational expert testifies that the
claimant’s use of an assistive device would render him or her unable to
work, the ALJ must set forth the reasons for rejecting this expert
testimony. 128
125
Howze v. Barnhart, 53 F. App’x 318, 222 (3d Cir. 2002) (citing SSR 96-
9p).
126
Steward v. Comm'r of Soc. Sec., 2009 WL 1783533, at *5 (W.D. Pa.
June 23, 2009).
127
Id.
128
Altomare v. Barnhart, 394 F. Supp. 2d 678, 682 (E.D. Pa. 2005).
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In the instant case, the ALJ acknowledged White’s testimony that
she required a cane for walking, as well as the medical records that
indicated White used a cane. 129 	But as we have noted, the ALJ found
that White’s testimony was not entirely consistent with the medical
evidence. 	Additionally, there are no medical records establishing that
the 	use 	of 	the 	cane 	was 	medically 	necessary 	or 	describing 	the
circumstance for which a cane was needed. Indeed, while the treatment
notes during the relevant period and the state agency opinions reference
White’s 	use 	of 	a 	cane, 	simply 	“[n]oting 	that 	Plaintiff 	used 	a 	cane
throughout 	treatment 	records 	. 	. 	. 	is 	insufficient 	to 	overcome 	the
threshold 	showing 	that 	the 	cane 	was 	medically 	necessary.” 130
Accordingly, we find this argument unavailing.
White next argues that the ALJ failed to adequately consider her
obesity in accordance with SSR 19-2p. 	The Third Circuit has explained
that the ALJ need not “use particular language or adhere to a particular
129 Tr. 23-25.
130
Russell William T. v. O’Malley, 2024 WL 4906490, at *10 (E.D. Pa.
Nov. 27, 2024) (citing
Howze, 53 F. App’x at 222).
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format in conducting his analysis” of a claimant’s obesity.131 	Rather, so
long as the ALJ “meaningfully consider[s] the effect of a claimant’s
obesity, individually and in combination with her impairments, on her
workplace function at step three and at every subsequent step[,]” a
remand is not required.132 	In the instant case, the ALJ recognized that
the plaintiff’s BMI during the relevant period was indicative of obesity
but found this impairment to be nonsevere.133 	While he acknowledged
the findings and the claimant’s testimony as to her obesity, he reasoned
that there was no evidence in the record to demonstrate that her obesity
had more than a minimal effect on her abilities or on her severe physical
impairments. 134 	The plaintiff fails to point to evidence showing that her
obesity had more than a minimal effect on her abilities, and instead
generally refers to her physical impairments and her complaints that her
pain was worse with prolonged sitting, standing and walking. But as we
131
Diaz v. Comm’r of Soc. Sec., 577 F.3d 500, 504 (3d Cir. 2009) (citations
omitted).
132
Id. at 504;
See Woodson v. Comm’r Soc. Sec., 661 F. App’x 762, 765 (3d
Cir. 2016);
Cooper v. Comm’r of Soc. Sec., 563 F. App’x 904, 911 (3d Cir.
2014).
133 Tr. 21-22.
134
Id.
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have noted, the ALJ explained why he found White’s testimony not
entirely consistent with the medical evidence. 	Ultimately, we conclude
that the ALJ’s assessment of White’s obesity is supported by substantial
evidence.
Finally, White asserts that the ALJ failed to adequately develop the
record because there was no opinion from a consultative or examining
physician regarding White’s physical capabilities. Thus, she argues that
the ALJ’s RFC determination was improperly based on his lay opinion.
“ALJs have a duty to develop a full and fair record in social security
cases[.]”135 	But this duty “does not require a consultative examination
unless the claimant establishes that such an examination is necessary to
enable the ALJ to make the disability decision.”136 “The decision to order
a consultative examination is within the sound discretion of the ALJ.” 137
Here, the ALJ concluded, based on the opinions of the state agency
consultants, as well as the medical records and White’s testimony, that
she 	could 	perform 	a 	range 	of 	light 	work 	with 	additional 	postural
135 Ventura v. Shalala, 55 F.3d 900, 902 (3d Cir. 1995).
136
Thompson v. Halter, 45 F. App’x 146, 149 (3d Cir. 2002).
137
Id.
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limitations. 	Although the state agency opinions found that White could
perform a range of sedentary work, the ALJ explicitly reasoned that he
increased White’s standing and walking capabilities based on White’s
own testimony that her pain was well-managed with medication. 	This
finding was supported by the medical records in 2023 that demonstrated
White’s pain was adequately managed with her medications. 	While the
plaintiff contends that a consultative examination was necessary, she
fails 	to 	demonstrate 	that 	there 	was 	an 	unexplained 	conflict 	or
inconsistency in the evidence that would have required the ALJ to order
a consultative examination.138 	Therefore, a remand is not required.
Given that the ALJ considered all the evidence and adequately
explained the decision for including or discounting certain limitations as
established 	by 	the 	evidence, 	we 	find 	no 	error 	with 	the 	decision.
Therefore, under the deferential standard of review that applies to
appeals of Social Security disability determinations, we conclude that
substantial evidence supported the ALJ’s evaluation of this case, and this
decision will be affirmed.
138
See 20 C.F.R. 416.920b.
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IV. 	Conclusion
For the foregoing reasons, the decision of the Commissioner in this
case will be affirmed, and the plaintiff’s appeal denied.
An appropriate order follows.
Submitted this 23rd day of February 2026.
s/ Daryl F. Bloom
Daryl F. Bloom
Chief United States Magistrate Judge
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