Case Name in Social Security Case - Unavailable

IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF PENNSYLVANIA
ELIZABETH NICOLE MARSHALL, 	: Civil No. 1:25-CV-480
:
Plaintiff, 	:
:
v. 	:
: (Chief Magistrate Judge Bloom)
FRANK BISIGNANO, 	:
Commissioner of Social Security, 	:
:
Defendant. 	:
MEMORANDUM OPINION
I. 	Introduction
Elizabeth Marshall filed an application under Title II of the Social
Security Act for disability and disability insurance benefits on May 12,
2022.1 Following a hearing before an Administrative Law Judge (“ALJ”),
the ALJ found that Marshall was not disabled from her alleged onset date
of February 10, 2022, through May 16, 2024, the date of the ALJ’s
decision. 2
Marshall now appeals this decision, arguing that the ALJ’s decision
is not supported by substantial evidence. 	After a review of the record,
1 Tr. 22.
2 Tr. 22-33.
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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,’” 3 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
Marshall 	filed 	for 	disability 	and 	disability 	insurance 	benefits,
alleging disability due to chronic lower back and neck pain, degenerative
disc disease, scoliosis, arthritis, lumbar radiculopathy, numbness and
tingling 	of 	the 	upper 	and 	lower 	extremities, 	Type 	2 	diabetes,
gastroesophageal 	reflux 	disease 	(“GERD”), 	post-traumatic 	stress
disorder (“PTSD”), and sleep apnea. 4 	Marshall was 49 years old at the
time 	of 	her 	alleged 	onset 	of 	disability, 	had 	at 	least 	a 	high 	school
education, and had past relevant work as a sales attendant, merchandise
displayer, and bill collector. 5
3
Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019).
4 Tr. 246.
5 Tr. 31-32.
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The medical record regarding Marshall’s impairments6 revealed
that in March of 2021, Marshall presented at WellSpan Orthopedics with
Dr. Craig Sullivan for an urgent care follow-up visit after a fall on stairs. 7
She reported left shoulder and right middle finger pain, as well as
occasional tingling in her arm. 8 	X-rays revealed no acute findings, 9 but
she claimed the pain hindered her ability to dress and lay on her side. 10
Dr. Sullivan noted signs of rotator cuff disease and ordered an MRI, 11
which showed a high-grade complex tear of the supraspinatus tendon,
mild partial-thickness tearing of the infraspinatus tendon, underlying
rotator cuff tendinosis, mild tendinosis of the biceps long head intra-
articular segment, degeneration and attrition of the glenoid labrum, and
mild 	acromioclavicular 	joint 	osteoarthrosis. 12 	Dr. 	Sullivan 	advised
Marshall to obtain a second opinion for treatment and referred her to Dr.
6 Because Marshall’s appeal focuses on the ALJ’s treatment of evidence
related to her physical impairments, 	we will forego discussion and
analysis of Marshall’s mental health records and evaluations.
7 Tr. 947.
8
Id.
9 Tr. 922.
10 Tr. 947.
11 Tr. 949.
12 Tr. 937.
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John 	Deitch, 13 	who 	recommended 	Marshall 	undergo 	a 	arthroscopic
procedure for a rotator cuff repair with possible debridement.14 	This
procedure occurred on February 16, 2022.15
In April of 2022, Marshall presented to Dr. Deborah Bernal for
complaints of widespread body pain. 16 	Marshall described her pain as
“aching, sharp shooting, throbbing with constant cramps and spasms
with associated weakness, paresthesia, sensitivity to touch, and sleep
disturbances.”17 Dr. Bernal diagnosed her with chronic bilateral low back
pain without sciatica, cervicalgia, vitamin D deficiency, numbness and
tingling, and noted a scoliosis concern. 18 Dr. Bernal recommended a four
month medical marijuana trial for pain management and ordered a
scoliosis X-ray, which revealed a left curvature in her spine.19
13 Tr. 939.
14 Tr. 931.
15 Tr. 346.
16 Tr. 731.
17
Id.
18 Tr. 728.
19 Tr. 725-28.
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A week later, Marshall appeared for a post-operative visit with Dr.
Deitch complaining of shoulder pain after breaking up a dog fight. 20 	A
physical examination revealed painful active motion, but an ability to do
active scapular plane abduction with a negative drop arm sign. 21 	Dr.
Deitch also noted no significant swelling and good strength with resisted
external rotation without lag.22 	In May of 2021, Marshall continued to
report shoulder pain associated with intermittent redness, tingling, and
painful popping. 23 	An MRI revealed no evidence of a retear but showed
slight fluid around the biceps tendon.24 Marshall received a subacromial
injection providing posterior to superior shoulder pain relief, but she
continued to have anterior pain. 25 	A physical examination revealed
soreness in the bicipital groove and positive Speed’s and O’Brien’s tests. 26
20 Tr. 898.
21 Tr. 899.
22
Id.
23 Tr. 1092.
24 Tr. 438-39.
25
Id.
26
Id.
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It 	was 	recommended 	that 	Marshall 	receive 	an 	ultrasound-guided
bicipital groove injection. 27
In August of 2022, Marshall underwent a left hand ring finger
flexor tendon sheath sharp excisional irrigation and debridement for
flexor tenosynovitis after sustaining a dog bite.28 Marhsall’s surgeon, Dr.
Michael Corum, noted she was progressing well and as expected after the
procedure.29 An occupational therapy (“OT”) evaluation around this time
revealed Marshall had expected injury and operative stiffness, weakness,
and coordination of the left hand with an overall moderate level of
functional impairment.30 Marshall attended OT sessions for two months
but continued to experience pain, stiffness, and decreased grip strength.31
On October 26, 2022, Marshall was discharged from OT due to a plateau
in progress. 32
27
Id.
28 Tr. 374.
29 Tr. 377.
30 Tr. 385.
31 Tr. 390, 395, 465, 468, 471, 475, 477, 487, 489, 491, 493, 495-96, 499-
500.
32 Tr. 499.
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In November of 2022, an MRI of Marshall’s hand depicted mild fluid
along the ring finger proximal interphalangeal (“PIP”) joint indicating
potential reactive edema injury. 33 A left ring finger PIP joint contracture
release was arranged, 34 but she continued to report numbness and pain
following the procedure.35 	This same month, Marshall presented to Dr.
Deitch 	for 	a 	reevaluation 	of 	her 	left 	shoulder 	due 	to 	continued
discomfort.36 Dr. Deitch noted Marshall had full range of motion and
strength despite her complaints and cleared her to return to work
without any restrictions from a shoulder standpoint. 37
In June of 2023, Marshall received a carpel tunnel injection given
her 	lack 	of 	improvement, 	which 	helped 	the 	range 	of 	motion 	and
discomfort in her left ring finger. 38 	In August of 2023, Marshall was
diagnosed with carpal tunnel syndrome, chronic hand pain, stiffness of
finger 	joint, 	and 	dog 	bite 	of 	the 	left 	hand 	including 	fingers 	with
33 Tr. 1001.
34
Id.
35 Tr. 622, 893
36 Tr. 546.
37
Id.
38 Tr. 1955.
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infection. 39 It was recommended that Marshall undergo a left endoscopic
carpal tunnel release, which occurred on August 18, 2023. 40 	Post-
operative treatment notes indicate Marshall was “nearly tip to palm with
all 	digits.” 41 	She 	reported 	improvement 	aside 	from 	some 	residual
dysesthesias in the fingers in the median nerve distribution. 42
In September of 2023, Marshall appeared for a follow-up visit with
Dr. Bernal regarding her chronic lower back pain. 43 	Dr. Bernal noted
that 	Marshall 	was 	non-compliant 	with 	taking 	her 	vitamin 	D
supplements, 	attending 	myofascial 	massage 	sessions, 	or 	utilizing 	a
TENS unit. 44 In November of 2023, Marshall sustained a fall that caused
pain along her palm into her volar wrist and ulnocarpal joint. 45 	X-rays
of the left wrist and a physical exam revealed degenerative changes of
her 	thumb 	carpometacarpal 	(“CMC”) 	joint 	and 	tenderness 	over 	the
39 Tr. 1958.
40 Tr. 1958-59.
41 Tr. 1878, 1911.
42 Tr. 1878.
43 Tr. 1902.
44
Id.
45 Tr. 1837-38.
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ulnocarpal joint in the area of the ulnar styloid. 46 	CMC joint steroid
injections were administered, which provided no relief. 47 	An MRI was
ordered 	due 	to 	Marshall’s 	lack 	of 	improvement 	despite 	activity
modification, 	therapeutic 	exercises, 	and 	wrist 	immobilization 	and
supportive wrapping. 48 	MRI imaging revealed right wrist/radial sided
proximal 	hand 	osteoarthrosis, 	chronic 	tearing 	of 	the 	triangular
fibrocartilage complex, and mild extensor carpi ulnaris tendinosis. 49
It is against the backdrop of this record that an ALJ held a hearing
on Marshall’s disability application on April 15, 2024.50 	Marshall and a
Vocational 	Expert 	both 	appeared 	and 	testified 	at 	this 	hearing. 51
Following this hearing, on May 16, 2024, the ALJ issued a decision
denying Marshall’s application for disability benefits. 52 	The ALJ first
concluded that Marshall had not engaged in substantial gainful activity
46 Tr. 1841.
47 Tr. 1709-10, 1837, 1842.
48 Tr. 1713.
49 Tr. 1226.
50 Tr. 41-55.
51
Id.
52 Tr. 22-33.
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since her alleged onset date of February 10, 2022.53 	At Step 2 of the
sequential analysis that governs disability claims, the ALJ found that
Marshall suffered from severe impairments of major depressive disorder,
PTSD, and personality disorder. 54 The ALJ further concluded that while
Marshall suffered from several other physical impairments, including a
dog bite to the left hand, tenosynovitis of the left ring finger, CMC joint
arthritis of the thumbs, left rotator cuff tear, osteoarthritis of the left
wrist, obesity, osteoarthritis of the knees, degenerative disc disease of the
lumbar spine and cervical spine, left carpal tunnel syndrome, vitamin D
deficiency, 	a 	back 	lipoma, 	gastroesophageal 	reflux 	disease, 	diabetes
mellitus, and obstructive sleep apnea, these impairments were non-
severe. 55 	At Step 3, the ALJ concluded that none of these impairments
met 	or 	equaled 	the 	severity 	of 	a 	listed 	impairment 	under 	the
Commissioner’s regulations.56 	Specifically, the ALJ found that Marshall
53 Tr. 24.
54 Tr. 24-26.
55
Id.
56 Tr. 26-28.
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experienced, at most, mild to moderate limitations in the four broad areas
of mental functioning. 57
Between Steps 3 and 4, the ALJ then concluded that Marshall:
[H]a[d] the residual functional capacity to perform a full
range of work at all exertional levels but with the following
nonexertional limitations: Work that is limited to simple and
routine tasks, involving only simple, work-related decisions,
and with few, if any, workplace changes, and only occasional
interaction with supervisors and coworkers. 58
In 	reaching 	this 	RFC 	determination, 	the 	ALJ 	considered 	the
objective medical record detailed above, the medical opinion evidence,
and Marshall’s reported symptoms. With respect to the medical opinion
evidence, 	the 	ALJ 	considered 	the 	opinions 	of 	the 	state 	agency
psychological consultants, Drs. John Gavazzi and Paul Terren, who found
that 	Marshall 	had 	a 	mild 	limitation 	pertaining 	to 	understanding,
remembering, 	or 	applying 	information 	and 	a 	moderate 	limitation
pertaining 	to 	interacting 	with 	others, 	concentration, 	persistence, 	or
maintaining pace, and adapting or managing oneself.59 	The ALJ found
57
Id.
58 Tr. 28.
59 Tr. 60-62, 68-71.
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these opinions persuasive given their consistency with the longitudinal
record. 60
The ALJ also considered the opinion of the state agency medical
consultant, Dr. Carl Ritner, who concluded Marshall does not have a
severe physical impairment. 61 The ALJ found this opinion persuasive as
it 	is 	consistent 	with 	the 	evidence 	of 	record, 	including 	“clinical
examination findings of normal coordination, no abnormal muscle tone,
and normal reflexes; the claimant’s lack of persistent treatment for
symptoms related to all of her physical impairments; and the claimant’s
own report that she has no problems dressing, bathing, caring for her
hair, feeding herself, and using the toilet, she does dishes, floors, and
dusts, and she drives.”62
Lastly, the ALJ considered the opinions of Dr. Corum and Jacob
Sterner, PT, and found them to be unpersuasive.63 Dr. Corum found that
Marshall could not lift, push, or pull greater than one pound with the left
60 Tr. 30.
61 Tr. 58-59.
62 Tr. 31.
63
Id.
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upper extremity and could not perform repetitive activity. 64 	The ALJ
explained that Dr. Corum’s opinion was not consistent with all of the
evidence of record, which included findings of normal coordination and
reflexes, an ability to nearly form a full fist, and an admitted capability
of performing daily activities such as bathing, dressing, feeding herself,
toileting, caring for her hair, and cleaning. 65 The ALJ further noted that
Dr. Corum recognized Marshall’s negative EMG results. 66
Mr. Sterner limited Marshall to a sedentary exertional level. 67 The
ALJ found this opinion was not consistent with the longitudinal record. 68
Specifically, the ALJ noted the lack of persistent abnormal findings of
Marshall’s lumbar spine, cervical spine, and lower extremities.69 	The
ALJ further recognized normal findings pertaining to Marshall’s reflexes,
coordination, 	and 	her 	self-reports 	of 	her 	ability 	to 	perform 	daily
activities. 70
64 Tr. 959, 962, 1955.
65 Tr. 31.
66
Id.
67 Tr. 2080-86.
68 Tr. 31.
69
Id.
70
Id.
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With respect to Marshall’s physical symptoms, the ALJ found that
Marshall’s statements concerning the intensity, persistence, and limiting
effects of her impairments were not entirely consistent with the medical
evidence. 71 	Marshall testified that she stopped working in February of
2022 due to surgery on her left shoulder. 72 	Marshall also underwent
surgery on her left hand ring finger and left hand carpal tunnel. 73 	She
reported lack of movement in her left ring finger and that she experiences
pain in her right hand and shoulder, knees, feet, lower back, neck, and
lower abdomen. 74 As to her physical capabilities, Marshall testified that
she can only stand comfortably for about 15 to 20 minutes without
difficulty, has a lifting/carrying capacity of five pounds in her left hand
and ten pounds in her right hand, and has difficulty typing. 75 	While
Marshall reported difficulty performing household tasks, she indicated
that she can do the dishes and take care of her chickens. 76
71 Tr. 29-31
72 Tr. 42.
73 Tr. 45.
74 Tr. 45-46.
75 Tr. 46-47.
76 Tr. 48.
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The ALJ ultimately found Marshall’s testimony to be inconsistent
with the objective clinical findings. 77 	The ALJ recounted the objective
evidence during the alleged disability period, including unremarkable
MRI imaging of 	the left hand and examination findings of normal
coordination, no abnormal muscle tone, normal reflexes, and an ability to
actively extend and flex all digits in the left hand with near full flexion
of the left ring finger.78 The ALJ also noted evidence that Marshall went
hunting in October of 2022 and reported she has no problems performing
daily activities in January of 2023.79 	Moreover, the ALJ recognized that
medical records failed to demonstrate Marshall persistently reported
symptoms that were attributed to her physical impairments by an
acceptable 	medical 	source.80 	Ultimately, 	the 	ALJ 	concluded 	that
Marshall was not as limited as she alleged.
Having made these findings, the ALJ found at Step 4 that Marshall
is unable to perform past relevant work but found at Step 5 that she could
77 Tr. 24-26, 29-31.
78 Tr. 25.
79
Id.
80 Tr. 25-26.
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perform the occupations of a laundry sorter, marker, and mailer sorter. 81
Accordingly, the ALJ found that Marshall had not met the stringent
standard prescribed for disability benefits and denied her claim. 82
This appeal followed. 	On appeal, Marshall argues that the ALJ’s
decision is not supported by substantial evidence. 83 	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.84 	Substantial
evidence “does not mean a large or considerable amount of evidence, but
rather such relevant evidence as a reasonable mind might accept as
81 Tr. 31-32.
82 Tr. 33.
83
See Doc. 13.
84
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.” 85 	Substantial evidence means less
than a preponderance of the evidence but more than a mere scintilla.86
A single piece of evidence is not substantial evidence if the ALJ
“ignores, 	or 	fails 	to 	resolve, 	a 	conflict 	created 	by 	countervailing
evidence.”87 	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.” 88 	The court must “scrutinize
the record as a whole” to determine if the decision is supported by
substantial evidence. 89
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
85
Pierce v. Underwood, 487 U.S. 552, 565 (1988).
86
Richardson v. Perales, 402 U.S. 389, 401 (1971).
87
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).
88
Consolo v. Fed. Maritime Comm’n, 383 U.S. 607, 620 (1966).
89
Leslie v. Barnhart, 304 F. Supp. 2d 623, 627 (M.D. Pa. 2003).
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support a conclusion.’”90 	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.”91 	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. 92
When conducting this review, we must remain mindful that “we
must not substitute our own judgment for that of the fact finder.” 93 Thus,
we cannot re-weigh the evidence. Instead, we must determine whether
90
Biestek, 139 S. Ct. at 1154 (quoting
Consolidated Edison Co. v. NLRB,
305 U.S. 197, 229 (1938)).
91
Id.
92
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 . . . .”).
93
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.94 	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. 95 	Ultimately, 	the 	ALJ’s 	decision 	must 	be
accompanied by “a clear and satisfactory explication of the basis on which
it rests.” 96
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
94
Burnett v. Comm’r of Soc. Sec. Admin., 220 F.3d 112, 119 (3d Cir. 2000).
95
See Diaz v. Comm’r of Soc. Sec., 577 F.3d 500, 504 (3d Cir. 2009)
(citations omitted).
96
Cotter v. Harris, 642 F.2d 700, 704 (3d Cir. 1981).
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than 12 months.” 97 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.” 98 	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. 99
In 	making 	this 	determination, 	the 	ALJ 	follows 	a 	five-step
evaluation. 100 	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”).101
97 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).
98 	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).
99 42 U.S.C. §423(a); 20 C.F.R. §404.131(a).
100 20 C.F.R. §§404.1520(a), 416.920(a).
10120 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
RFC. 	RFC is defined as “that which an individual is still able to do
despite the limitations caused by his or her impairment(s).”102 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. 103 	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. 104
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. 105 	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
102
Burnett, 220 F.3d at 121 (citations omitted);
see also 20 C.F.R. §
404.1545(a)(1).
103 20 C.F.R. §§404.1545(a)(2), 416.945(a)(2).
104
Burns v. Barnhart, 312 F.3d 113, 129 (3d Cir. 2002).
105
Mason, 994 F.2d at 1064.
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consistent 	with 	the 	claimant’s 	RFC, 	age, 	education, 	and 	work
experience. 106
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.” 107 	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.” 108
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
106 20 C.F.R. §§404.1512(f), 416.912(f);
Mason, 994 F.2d at 1064.
107
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).
108
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. 109
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.110 	Ultimately, it is our task to
determine, 	considering 	the 	entire 	record, 	whether 	the 	RFC
determination is supported by substantial evidence. 111
C. Step 2 Analysis
At Step 2, the ALJ determines whether a claimant has a medically
severe impairment or combination of impairments. 112 	An impairment is
considered severe if it “significantly limits an individual’s physical or
109
Biller, 962 F. Supp. 2d at 778–79.
110
See Titterington, 174 F. App’x 6;
Cummings, 129 F. Supp. 3d at 214–
15.
111
Burns, 312 F.3d 113.
112
Bowen v. Yuckert, 482 U.S. 137, 140–41 (1987).
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mental abilities to do basic work activities,” 113 or if it is “something
beyond ‘a slight abnormality which would have no more than a minimal
effect on an individual’s ability to work.’” 114 	This Step 2 inquiry is a de
minimis screening device used to cast out meritless claims.115 	The
claimant 	bears 	the 	burden 	to 	show 	that 	an 	impairment 	should 	be
considered severe.116
D. 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
claimant, 	specialization, 	and 	other 	factors 	tending 	to 	support 	or
contradict a medical opinion. 117 	Supportability and consistency are the
two most important factors, and an ALJ must explain how these factors
113 20 C.F.R. 404.1520(c),
114
McCrea v. Comm’r of Soc. Sec., 370 F.3d 357, 360 (3d Cir. 2004)
(citations omitted).
115
Id.;
Newell v. Comm’r of Soc. Sec., 347 F.3d 541, 546 (3d Cir. 2003).
116
Bowen, 482 U.S. at 146;
Stancavage v. Saul, 469 F. Supp. 3d 311, 331
(M.D. Pa. 2020)
117 20 C.F.R. § 404.1520c(c).
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were considered in his or her written decision. 118 	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.”119 	The consistency
factor focuses on how consistent the opinion is “with the evidence from
other medical sources and nonmedical sources.”120
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.” 121 	When confronted with
several medical opinions, the ALJ can choose to credit certain opinions
over others but “cannot reject evidence for no reason or for the wrong
reason.” 122 Further, the ALJ can credit parts of an opinion without giving
credit to the whole opinion and may formulate a claimant’s RFC based
118 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).
119 20 C.F.R. §§ 404.1520c(c)(1), 416.920c(c)(1).
120 20 C.F.R. §§ 404.1520c(c)(2), 416.920c(c)(2).
121
Chandler v. Comm’r of Soc. Sec., 667 F.3d 356, 361 (3d Cir. 2011).
122
Mason, 994 F.2d at 1066.
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on different parts of different medical opinions, so long as the rationale
behind the decision is adequately articulated. 123 	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.” 124
E. 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. 125 	Our review of those determinations is deferential. 126
However, it is incumbent upon the ALJ to “specifically identify and
explain what evidence he found not credible and why he found it not
credible.” 127 	An ALJ should give great weight to a claimant’s testimony
“only when it is supported by competent medical evidence.” 128 	As the
123
See Durden v. Colvin, 191 F. Supp. 3d 429, 455 (M.D. Pa. 2016).
124
Cummings, 129 F. Supp. 3d at 214–15.
125
See Diaz, 577 F.3d at 506.
126
Id.
127
Zirnsak, 777 F.3d at 612 (citations omitted).
128
	McKean v. Colvin, 150 F. Supp. 3d 406, 415–16 (M.D. Pa. 2015)
(citations omitted).
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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.”129
The Social Security Rulings and Regulations provide a framework
for evaluating the severity of a claimant’s reported symptoms.130 	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.131
Symptoms such as pain or fatigue will be considered to affect a
claimant’s ability to perform work activities only if medical signs or
laboratory findings establish the presence of a medically determinable
impairment that could reasonably be expected to produce the alleged
symptoms. 132 	During the second step of this assessment, the ALJ must
129
	Chandler, 	667 	F.3d 	at 	363 	(referencing 	20 	C.F.R. 	§404.1529(a)
(“statements about your pain or other symptoms will not alone establish
that you are disabled”).
130 20 C.F.R. §§ 404.1529, 416.929; SSR 16–3p.
131 SSR 16-3p.
132 20 C.F.R. §§ 404.1529(b), 416.929(b); SSR 16–3p.
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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. 133 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. 134
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. 135 	Thus, to assist in the evaluation of a claimant’s subjective
symptoms, the Social Security Regulations set forth seven factors that
may be relevant to the assessment of the claimant’s alleged symptoms. 136
These 	factors 	include: 	the 	claimant’s 	daily 	activities; 	the 	“location,
duration, frequency, and intensity” of the claimant’s pain or symptoms;
133 20 C.F.R. § 404.1529(c), 416.929(c); SSR 16–3p.
134
Id.
135 SSR 16-3p.
136 20 C.F.R. §§ 404.1529(c)(3), 416.929(c)(3).
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the type, dosage, and effectiveness of medications; treatment other than
medications; 	and 	other 	factors 	regarding 	the 	claimant’s 	functional
limitations. 137
F. 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.’”138 	Judged against this deferential
standard of review, we conclude that substantial evidence supported the
ALJ’s decision in this case.
Marshall generally argues the ALJ erred in finding that she does
not have a severe physical impairment that limits her ability to work. 139
To the extent that Marshall’s argument is made by pointing to record
evidence that she contends supports abnormal physical findings, such
137
Id.
138
Biestek, 139 S. Ct. at 1154.
139 Doc. 13 at 3, 24-31; Doc. 18.
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argument is unavailing. 140 	It is well settled that courts reviewing an
ALJ’s decision “must not substitute our own judgment for that of the fact
finder.” 141 	Indeed, we are not permitted at this stage to reweigh the
evidence. 142
In any event, we find the ALJ adequately explained why he found
Marshall’s physical impairments to be non-severe. 	The ALJ discussed
the following physical impairments at Step 2 and found them to be non-
severe: 	a dog bite to the left hand, tenosynovitis of the left ring finger,
CMC joint arthritis of the thumbs, left rotator cuff tear, osteoarthritis of
the left wrist, obesity, osteoarthritis of the knees, degenerative disc
disease 	of 	the 	lumbar 	spine 	and 	cervical 	spine, 	left 	carpal 	tunnel
syndrome, vitamin D deficiency, a back lipoma, gastroesophageal reflux
disease, 	diabetes 	mellitus, 	and 	obstructive 	sleep 	apnea. 	The 	ALJ
140 Doc. 13 at 27 n. 18.
141
Zirnsak, 777 F.3d at 611 (citing
Rutherford, 399 F.3d at 552);
see also
Williams v. Sullivan, 970 F.2d 1178, 1182 (3d Cir. 1992) (“Neither the
district court nor this court is empowered to weigh the evidence or
substitute [our] conclusions for those of the fact-finder.”) (citing
Early v.
Heackler, 743 F.2d 1002, 1007 (3d Cir. 1984)).
142
Chandler, 667 F.3d at 359.
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thoroughly 	detailed 	the 	medical 	record 	and 	Marshall’s 	testimony
regarding her physical impairments.
As to Marshall’s dog bite of the left hand and tenosynovitis of the
left ring finger, the ALJ noted her reports of pain and numbness,
disfigurement, lack of movement in her left finger, and five-pound lift
limitation with her left hand. 143 	However, the ALJ further noted that
Marshall went hunting a few months after surgery, was able to flex all
digits of the left hand with near full flexion of the left ring finger, the MRI
imaging showed intact flexor and extensor tendons, her January 2023
function report indicated she has no problem performing daily activities,
treatment records indicated the surgical incision healed, and clinical
examination findings of normal coordination, no abnormal muscle tone,
and normal reflexes. 144
The 	ALJ 	next 	assessed 	Marshall’s 	CMC 	joint 	arthritis 	of 	the
thumbs, left rotator cuff tear, osteoarthritis of the left wrist, obesity,
osteoarthritis of the knees, degenerative disc disease of the lumbar spine
143 Tr. 24-25.
144 Tr. 25.
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and cervical spine, and left carpal tunnel syndrome. The ALJ recognized
Marshall’s claims of widespread pain, her ability to only be on her feet
for 15 to 20 minutes, and her ten-pound lift limitation with her right
hand. 145 	Despite these abnormal allegations, the ALJ further noted that
the 	medical 	records 	do 	not 	indicate 	Marshall 	persistently 	reported
experiencing symptoms or was persistently assessed with abnormal
clinical examination findings that were attributed to these impairments
by an acceptable medical source. 146 	Indeed, the ALJ again recognized
Marshall’s reported ability to perform a wide range of daily activities.
The ALJ made the same findings as to Marshall’s vitamin D deficiency,
back lipoma, gastroesophageal reflux disease, diabetes mellitus, and
obstructive sleep apnea, and further recognized her failure to allege
ongoing symptoms during her testimony. 147
Ultimately, the ALJ found that Marshall’s physical impairments
were non-severe. Given that it is the claimant’s burden to prove that an
impairment is severe at Step 2, we conclude that the ALJ’s Step 2
145 Tr. 25-26.
146
Id.
147 Tr. 26.
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decision is supported by substantial evidence and does not require a
remand.
Marshall also challenges the ALJ’s treatment of medical opinion
evidence. 	She argues the ALJ erred in failing to acknowledge that a
significant amount of evidence came into the record after the state agency
consultants’ review while finding their opinions persuasive. 148 	“The
Social Security regulations impose no limit on how much time may pass
between a report and the ALJ’s decision in reliance on it.”149 	It is “[o]nly
where ‘additional medical evidence is received that
in the opinion of the
[ALJ] . . . may change the State agency medical . . . consultant’s finding
that the impairment(s) is not equivalent in severity to any impairment
in the Listing,’ is an update to the report required.”150 	Nevertheless,
“where evidence can be read to indicate that a plaintiff’s condition
deteriorated after the state agency reviewer issued his opinion, . . . the
148 Doc. 13 at 29.
149
Chandler, 667 F.3d at 361.
150
Id. (quoting SSR 96–6p (July 2, 1996) (emphasis added)).
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ALJ’s reliance on that opinion [may be] troubling.” 151 	Ultimately, an
“ALJ’s reliance on the opinion of a reviewing consultant who did not have
all relevant records requires thorough explanation.” 152
In support of this argument, Marshall merely points to nearly 1,000
pages of the record that contain medical evidence dated both before and
after the state agency review. 	However, this observation alone, without
more, is insufficient to demonstrate a deterioration in a claimant’s
condition. 153 	Accordingly, we conclude this argument is without merit
and find no basis for remand.
Marshall further argues that the ALJ failed to consider that the
opinions 	of 	Dr. 	Corum 	and 	Mr. 	Sterner 	were 	consistent 	with 	each
151
Batdorf v. Colvin, 206 F. Supp. 3d 1012, 1024 (M.D. Pa. 2016) (internal
quotations omitted);
see also Garcia v. Dudek, No. 1:24-CV-00194, 2025
WL 674226, at *9 (M.D. Pa. Mar. 3, 2025) (collecting cases).
152
Batdorf, 206 F. Supp. 3d at 1024–25;
see also Burton v. Kijakazi, No.
20-196, 2022 WL 125368, at *2 (W.D. Pa. Jan. 13, 2022) (“The ALJ . . .
clearly considered the record postdating the consultant’s opinion . . . and
adequately explained his reasons for accepting or rejecting pertinent
parts of the record.”).
153
See Gambriel v. Kijakazi, No. 1:20-CV-01393, 2022 WL 808496, at *7
(M.D. Pa. Mar. 16, 2022);
Caiazzo v. Saul, No. 3:19-CV-02008, 2021 WL
7967588, at *2 (M.D. Pa. Apr. 28, 2021).
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other. 154 	Her argument is grounded on the premise that some evidence
in the record supports the limitations set forth by each opinion. 	But as
explained 	above, 	we 	may 	not 	reweigh 	the 	evidence. 	Contrary 	to
Marshall’s argument, the ALJ was not required to specify whether the
opinions were consistent with each other. 155 	The ALJ found Dr. Corum’s
opinion unpersuasive, reasoning that the opinion was not supported by
his own examination findings, nor was it consistent with the objective
medical evidence or Marshall’s own self-report. 156 	Similarly, the ALJ
found 	Mr. 	Sterner’s 	opinion 	unpersuasive, 	concluding 	it 	was 	not
consistent with the objective medical examination findings pertaining to
Marshall’s 	lumbar 	spine, 	cervical 	spine, 	lower 	extremities, 	reflexes,
coordination, and activities of daily living. 157 	Ultimately, the ALJ was
confronted 	with 	several 	medical 	opinions 	that 	set 	forth 	varying
restrictions regarding Marshall’s ability to perform work. 	The ALJ
adequately 	explained 	why 	he 	found 	the 	opinions 	not 	persuasive.
154 Doc. 13 at 29-31.
155
Christine F. B. v. Bisignano, No. CV 24-5210, 2025 WL 1830603, at *6
(E.D. Pa. June 30, 2025).
156 Tr. 31.
157
Id.
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Accordingly, 	we 	conclude 	that 	the 	ALJ’s 	treatment 	of 	the 	medical
opinions is supported by substantial evidence.
We reach a similar conclusion with respect to the consideration of
Marshall’s subjective symptoms. 	As detailed above, the ALJ discussed
the 	objective 	medical 	evidence 	pertaining 	to 	Marshall’s 	physical
impairments, as well as her testimony concerning the same. 	However,
the ALJ concluded that Marshall’s allegations of her symptoms were not
consistent 	with 	the 	evidence 	in 	the 	record. 	Thus, 	while 	Marshall
challenges the ALJ’s credibility determination, we are not permitted at
this stage to reweigh the evidence, and instead must simply determine
whether the ALJ’s decision was supported by “substantial evidence.” 158
Here, we conclude that the ALJ’s consideration of Marshall’s subjective
symptoms is supported by substantial evidence.
Therefore, under the deferential standard of review that applies to
appeals of Social Security disability determinations, we conclude that
158
Chandler, 667 F.3d at 359;
Biestek, 139 S. Ct. at 1154.
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substantial evidence supported the ALJ’s evaluation of this case, and this
decision will be affirmed.
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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