Case Name in Social Security Case - Unavailable

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IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF PENNSYLVANIA
TERESA DANNER, 	: 	Civil No. 4:25-CV-285
:
Plaintiff, 	:
:
v. 	: 	(Magistrate Judge Carlson)
:
FRANK BISIGNANO, 	:
Commissioner of Social Security 	:
:
Defendant. 	:
MEMORANDUM OPINION
I. 	Introduction
This Social Security appeal involves a familiar challenge to a decision
denying the plaintiff’s claim. The plaintiff in this case, Teresa Danner, challenges
the decision of a Social Security Administrative Law Judge (ALJ) which found that
she had not met the exacting standards for disability under the Social Security Act.
In particular, on appeal Danner insists that the ALJ erred in considering the medical
opinion evidence by addressing two conflicting medical opinions as one and failing
to adequately articulate which limitations were deemed persuasive and which were
not. Upon review, we discovered that one of these medical experts opined that
Danner was subject to a limitation that has recently resulted in a rising tide of
remands – this expert opined that Danner could perform simple, one-to-two-step
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tasks. Moreover, the ALJ did not incorporate or address this limitation in the residual
functional capacity (RFC) assessment, despite finding the opinion of this expert
persuasive, a decision we have deemed to be reversible error in the absence of any
showing of harmless error. Whitney v. Bisignano, No. 4:24-CV-1950, 2026 WL
522922, at *10 (M.D. Pa. Feb. 25, 2026); 	Cruz v. Bisignano, No. 1:24-CV-1966,
2025 WL 2813882, at *7 (M.D. Pa. Sept. 30, 2025); Michelle M. v. Bisignano, No.
3:23-CV-02163, 2025 WL 2713737, at *7 (M.D. Pa. Sept. 23, 2025); Warren v.
Dudek, No. 1:24-CV-635, 2025 WL 1168276, at *6 (M.D. Pa. Apr. 22, 2025);
Shipman v. Kizakazi, No. 3:22-CV-00636, 2023 WL 5599607, at *10 (M.D. Pa.
Aug. 29, 2023).
Nonetheless, in considering the arguments of the plaintiff, we are enjoined to
consider any errors in the ALJ analysis in the factual context of the case applying a
harmless error analysis where remand is appropriate only where the error likely
affected the outcome of the proceeding. In this case, the undisputed testimony of a
vocational expert (VE) insulates the ALJ’s decision from remand under this
harmless error theory, since this vocational expert testified that the plaintiff could
still perform work that exists in the national economy even considering the most
conservative limitations opined by the medical experts, including the one-to-two-
step limitation.
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Moreover, while the plaintiff also challenges the ALJ’s evaluation of her
subjective symptoms, our review of this case is subject to a deferential standard of
review, a standard of review which simply asks whether there is “substantial
evidence” supporting the Administrative Law Judge’s (ALJ) determination. With
respect to this legal guidepost, as the Supreme Court has explained:
The phrase “substantial evidence” is a “term of art” used throughout
administrative law to describe how courts are to review agency
factfinding. T-Mobile South, LLC v. Roswell, 574 U.S. ––––, ––––,
135 S. Ct. 808, 815, 190 L.Ed.2d 679 (2015). Under the substantial-
evidence standard, a court looks to an existing administrative record
and asks whether it contains “sufficien[t] evidence” to support the
agency’s factual determinations. Consolidated Edison Co. v. NLRB,
305 U.S. 197, 229, 59 S. Ct. 206, 83 L.Ed. 126 (1938) (emphasis
deleted). And whatever the meaning of “substantial” in other contexts,
the threshold for such evidentiary sufficiency is not high. Substantial
evidence, this Court has said, is “more than a mere scintilla.” Ibid.; see,
e.g., Perales, 402 U.S. at 401, 91 S. Ct. 1420 (internal quotation marks
omitted). It means—and means only—“such relevant evidence as a
reasonable mind might accept as adequate to support a conclusion.”
Consolidated Edison, 305 U.S. at 229, 59 S. Ct. 206. See Dickinson v.
Zurko, 527 U.S. 150, 153, 119 S. Ct. 1816, 144 L.Ed.2d 143 (1999)
(comparing the substantial-evidence standard to the deferential clearly-
erroneous standard).
Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019).
In the instant case, after an independent 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,’” Biestek, 139 S.
Ct. at 1154, we find that substantial evidence supported the ALJ’s findings as to the
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plaintiff’s subjective symptoms and any error with regard to the analysis of the
medical opinion evidence was harmless. Therefore, for the reasons set forth below,
we will affirm the decision of the Commissioner.
II. 	Statement of Facts and of the Case
A. Danner’s Medical History and Expert Testimony Regarding Her
Mental Impairments
On April 15, 2022, Teresa Danner applied for disability insurance benefits
under Title II of the Social Security Act, alleging disability beginning February 25,
2021.1 (Tr. 19). 	According to Danner, she was totally disabled due to a series of
medical conditions, including PTSD, severe depression, severe anxiety, ulcerative
colitis, nightmares, IBS, sleep apnea, ADHD, and Graves disease. (Tr. 168). Danner
was born was born on August 3, 1978, and was forty-two years old, which is defined
as a younger individual by the Commissioner’s regulations, at the time of the alleged
onset of her disability. (Id.) She had a college education and had previously worked
as a corrections officer for the Federal Bureau of Prisons (FBOP) at the United States
Penitentiary at Lewisburg (USP Lewisburg). (Tr. 37).
1 Danner previously applied for disability benefits alleging an onset date of October
2016, when she left her prior employment. That application was denied, thus the
alleged onset date in the instant application is the day following the denial of that
application. (Tr. 67).
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Danner’s employment at USP Lewisburg is relevant to more than just the
question of whether the limitations caused by her conditions precludes her from
performing that prior job. Indeed, Danner testified that she was medically retired
from USP Lewisburg at least in part due to trauma resulting from sexual harassment
and discrimination she faced there. (Tr. 41-42). According to Danner, she was still
in the process of suing the BOP for gender discrimination and sexual harassment.
(Tr. 112). She testified that she is unable to be in contact with any men without
freezing and having a panic attack due to past childhood trauma as well as her
experience at USP Lewisburg. (Tr. 43-44).
The principal issues in this appeal relate to the ALJ’s symptom evaluation and
the evaluation of the medical opinion evidence in this case and particularly focus on
the ALJ’s treatment of Danner’s mental impairments of PTSD, anxiety, and
depression. With respect to these issues, the clinical evidence reveals the following:
The clinical record shows that Danner was treated for her mental health
disorders throughout the relevant period by psychiatrist Dr. Michael Turk. Prior to
the alleged onset date, at her initial psychiatric evaluation on August 3, 2020, Dr.
Turk noted that she had seen a psychiatrist for a few years prior who had recently
been arrested and his practice abruptly closed. (Tr. 726). Dr. Turk noted severe
depressive symptoms, PTSD symptoms with possible psychotic features, significant
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anxiety attacks, and probable agoraphobia. (Tr. 726). Danner also reported to Dr.
Turk that a number of times a year she experienced manic symptoms of decreased
need for sleep, hyper verbality, increased goal directed activity and disorganized
manner and thinking due to racing thoughts, irritable angry mood but Dr. Turk noted
that her depressive symptoms such as euthymic mood were mild. (Id.) Thus, Dr.
Turk diagnosed bipolar disorder with severe depressive symptoms and some
psychotic features, PTSD, and anxiety, but noted the symptomology she associated
with ADHD could be related to her other impairments. (Tr. 727).
At this evaluation, Danner also referenced the trauma from the sexual
harassment at her employer and childhood trauma playing into her PTSD symptoms
and reported trust issues, severely impaired concentration, and being restless and
easily distracted due to ADHD. (Id.) She also reported that her memory was
impaired, she had a past suicide attempt and daily passive suicidal thoughts and had
binge eating concerns. (Id.) On examination, Dr. Turk noted Danner displayed
euthymic mood and anxious depressed attitude but was cooperative and pleasant,
displayed appropriate affect, intact language and thought processes, full orientation,
and fair insight and judgment. (Tr. 728). Nonetheless, he observed impaired
attention span and concentration, anhedonia, depression, inappropriate guilt, self-
deprecatory ideas, victimization, thoughts of helplessness and worthlessness but no
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delusions or hallucinations. (Id.) Danner’s psychiatric medications were adjusted
and supportive therapy was recommended. (Tr. 729-30).
Dr. Turk’s treatment records during the relevant period, from February 25,
2021, through Danner’s date last insured, December 31, 2022, show ongoing
depressive symptoms and anxiety but that her sleep was improving and ADHD
symptoms improved with medication. (Tr. 750-820). It was also noted that her
bipolar disorder was improving but ongoing and “in partial remission.” (Tr. 754).
Though she frequently expressed feelings of anxiety, depression frustration, guilt,
and shame, (tr. 754, 756, 758, 771, 774, 784, 800, 825), and exhibited depressed
mood her mental examinations were also almost entirely unremarkable showing
intact attention span and concentration, cooperative attitude, and anxiety symptoms
lessening 	and 	bipolar 	improving 	overall, 	particularly 	when 	she 	was 	on 	her
psychiatric medications. (Tr. 784, 797, 800, 806, 810, 819, 825, 828, 837, 840, 843,
846, 849, 855, 857, 863, 869). There were only a few occasions her concentration
and attention span were decreased, especially when experiencing manic symptoms.
(Tr. 786-87, 793-94, 822). Nonetheless, overall, it appears from Dr. Turk’s records
that her bipolar was relatively well managed despite causing some limitations in her
ability to maintain motivation and perform daily tasks. She also expressed an ability
to go trick or treating, visit with family and friends for holidays, attend a birthday
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party, interact with neighbors, and homeschool her children. (Tr. 783, 802, 808, 839,
856, 955).
By May 2022 Danner noted improvements in her ADHD, PTSD, and
depressive symptoms, but stated that breakthrough symptoms did occur, and noted
anxiety and agoraphobia were ongoing. (Tr. 851). Her bipolar was noted as
improving overall. (Tr. 869). Treatment notes continued to show periods of
improvement with better and worse days through the end of 2022 with examination
notes remaining relatively unremarkable. (Tr. 917-950). By the end of the relevant
period, Dr. Turk noted she was handling triggers to anxiety and panic better but that
her anxiety could still get severe easily and maintained a moderate level of anxiety
in general. (Tr. 949). He stated that her attention, concentration, and depression
symptoms were ongoing but improving. (Id.) Thus, Danner’s clinical history
undoubtedly demonstrated that she struggled with anxiety, depression, PTSD, and
ADHD, but that her mental status exams were overwhelmingly normal and she was
still performing some normal activities of her daily life.
On this score, the ALJ highlighted her ability to perform many normal
activities despite her impairments. As the ALJ summarized:
Additionally, despite her testimony regarding severely limited activities
of daily living, the record suggests that she retains greater functional
abilities. First, in contrast to statements contained in her Function
Report, 	the 	claimant 	had 	often 	noted 	organizing, 	cleaning, 	and
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performing other household tasks at her treatment visits (Exhibits
B1F/55 and B3F/142). Further, the records show that the claimant has
been very involved with her children and their homeschooling during
the 	relevant 	period 	(Exhibits 	B2F/27, 	B3F/119, 	and 	B8F/11).
Moreover, there are indications that the claimant enjoys following
organized 	sports 	and 	has 	attended 	minor 	league 	baseball 	games
(Exhibits B1F/73 and B8F/2, 13). Although the claimant testified that
she had to leave games early due to psychologically based symptoms
or triggers, this allegation is not reflected in contemporaneous treatment
notes.
(Tr. 24).
Given this fairly benign clinical history, the medical opinion evidence was
particularly 	significant 	in 	determining 	whether 	Danner’s 	multiple 	emotional
impairments were wholly disabling. Notably, only two non-examining, non-treating
sources opined regarding the limiting effects of these impairments.2 Notably, neither
of these experts found Danner’s physical impairments to be disabling. Instead, on
July 27, 2022, Dr. Roger Fretz opined that Danner would be moderately limited in
all areas of mental functioning including understanding, remembering, or applying
information, interacting with others, concentrating, persisting, or maintaining pace,
and adapting or managing oneself. (Tr. 171). Specifically, Dr. Fretz opined that
Danner would be moderately limited in her ability to understand, remember, and
carry out detailed instructions, maintain attention and concentration for extended
2 No treating source, including her treating psychiatrist Dr. Turk, completed a mental
status assessment of Danner to accompany her most recent application.
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periods, sustain an ordinary routine, work in coordination and proximity with others
and complete a normal workday and workweek without interruption from her
symptoms. (Tr. 173). He also concluded she would be moderately limited in
interacting appropriately with the general public and getting along with coworkers
or peers, but that she would not be limited in accepting instructions and responding
to criticism from supervisors. (Id.) Moreover, Dr. Fretz opined that Danner would
be moderately limited in her ability to respond appropriately to changes in the work
setting and set realistic goals or make plans independently of others. (Id.) Dr. Fretz
explained that Danner had some difficulty with social engagement and could
misinterpret the intentions of others, was forgetful and had some difficulty with
concentration and maintaining pace and may have some difficulty learning new
material but that she was capable of performing simple tasks. (Tr. 173-74).
On reconsideration, a second State agency consultant who examined Danner’s
records reached different conclusions regarding the limiting effects of her mental
impairments. On October 26, 2022, Dr. Virginia Carolyn Martin opined that Danner
had 	only 	mild 	limitations 	in 	her 	ability 	to 	understand, 	remember, 	or 	apply
information and adapt or manage oneself, but, like Dr. Fretz, considered Danner’s
limitations in her ability to interact with others and concentrate, persist or maintain
pace to be moderate. (Tr. 181). Specifically, Dr. Martin opined that Danner had no
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understanding and memory or adaptation limitations but was moderately limited in
her ability to carry out detailed instructions, maintain attention and concentration for
extended periods, perform activities within a schedule, maintain regular attendance,
and be punctual within customary tolerances, work in coordination or proximity to
others, and complete a normal workday and workweek without interruptions from
her symptoms. (Tr. 183). Dr. Martin also concluded that Danner was moderately
limited in her ability to interact appropriately with the general public and get along
with coworkers or peers without distracting them but, like Dr. Fretz, opined she was
not significantly limited in responding appropriately to supervisors. (Id.) Dr. Martin
explained:
The claimant’s basic memory processes are intact. The claimant can
understand, retain, and follow simple instructions (i.e., perform one-
and two-step tasks). The claimant can make simple decisions and would
not require special supervision in order to sustain a routine. The
claimant can perform simple, routine, repetitive tasks in a stable
environment. The claimant is capable of performing within a schedule
and at a consistent pace.
The claimant is able to maintain socially appropriate behavior and can
perform the personal care functions needed to maintain an acceptable
level of personal hygiene. The claimant is capable of asking simple
questions and accepting instruction. The claimant is able to interact
appropriately with the general public. The claimant is able to get along
with 	others 	without 	distracting 	them. The 	claimant 	can 	exercise
appropriate judgment.
(Tr. 184).
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Thus, without the benefit of a treating source’s opinion, the ALJ was presented
with 	two 	non-treating, 	non-examining 	sources 	whose 	opinions 	were 	both
inconsistent with one another and internally inconsistent. On this score, while Dr.
Martin concluded Danner had no understanding, memory, or adaptation limitations,
she explained that Danner would be limited to simple one- and two-step tasks.
Conversely, Dr. Fretz concluded that Danner was moderately limited in all spheres
of functioning, but did not include any limitation to one-to-two-step tasks.
It was against this medical background that Danner’s case came to be
considered by the ALJ.
B. The ALJ Hearing and Decision.
Another unusual aspect of this case is that three hearings were conducted
before three different ALJs before a decision was made. This series of hearings
remains mysterious and unexplained, with each subsequent ALJ simply noting that
the prior ALJ who heard the case was unable to issue a decision. (See Tr. 62, 97).
Thus, Danner testified before these ALJs on June 13, 2023, (tr. 33-59), November
14, 2023, (tr. 60-93), and May 6, 2024. (Tr. 94-136). At the first hearing, the ALJ
asked Danner if she would be able to perform the simple one-to-to-step jobs that had
been identified in the previous decision denying her disability benefits. Danner
testified that she could not do even simple one-to-two-step jobs if she is in contact
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with people, specifically that she freezes up and has panic attacks when she interacts
with any man due to her PTSD. (Tr. 43-44). At the hearing before the ALJ who
ultimately issued the decision in this case, Danner also testified that she would be
significantly functionally limited by her impairments. As the ALJ summarized:
With regard to her functional limitations, the claimant testified that her
short-term 	memory 	is 	poor, 	and 	she 	has 	significant 	difficulties
focusing. She rarely leaves her home and has difficulties being around
people. Her husband performs most of the daily activities including
shopping, errands, cooking and housekeeping. The claimant lives in her
pajamas and showers infrequently.
(Tr. 23).
A vocational expert (VE) also testified at the May 2024 hearing. The ALJ
posed a series of hypotheticals to the VE, including limitations that were more
restrictive than those the ALJ ultimately included in the final RFC. Even considering
these more restrictive functional limitations, the VE identified occupations the
plaintiff could perform. As the VE testified:
Q. And I’m going to give you a series of hypotheticals. Assume a
person of the claimant’s age, education and work experience that can
do the following. Individual can understand, carry out simple, routine
repetitive one to two step tasks, and can sustain attention for extended
periods of two hour segments, while maintaining regular attendance
and being punctual within customary limits. No interaction with the
public. And occasional interaction with co-workers but no tandem
tasks. Can they do the past job?
A. No, Your Honor.
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Q. How about any other types of occupations and we can keep it at the
light level?
A. Okay. Yes, Your Honor. Marker. DOT number 209.587-034.
Number of jobs in the national economy 50,000. This is light with an
SVP of 2. That of the mail clerk. DOT number 209.687-026. Number
of jobs in the national economy 70,000. This is light, with an SVP of 2.
And that of the garment sorter. DOT number 222.687-014. Number of
jobs in the national economy 200,000. This is light with an SVP of 2.
(Tr. 56). Thus, the VE testified that even if Danner were limited to simple, routine,
repetitive one-to-two-step tasks, she could perform the jobs of marker, mail clerk,
and garment sorter.
Following this hearing, on May 13, 2024, the ALJ issued a decision in
Danner’s case. (Tr. 14-32). In that decision, the ALJ first concluded that Danner did
not engage in substantial gainful activity during the period from her alleged onset
date of February 25, 2021, through her date last insured of December 31, 2022. (Tr.
19). At Step 2 of the sequential analysis that governs Social Security cases, the ALJ
found that Danner had the following severe impairments: a mental impairment
diagnosed to include post-traumatic stress disorder (PTSD), agoraphobia with panic
disorder, 	bipolar 	disorder, 	mixed 	anxiety 	disorder, 	and 	attention-
deficit/hyperactivity disorder (ADHD). (Id.)
At Step 3, the ALJ determined that Danner did not have an impairment or
combination of impairments that met or medically equaled the severity of one of the
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disability listing impairments. (Tr. 20-22). In considering whether her mental
impairments were severe, the ALJ considered the “paragraph B” areas of functional
limitations on which the State agency experts had opined. The ALJ seemingly
adopted the limitations opined by Dr. Martin, concluding that Danner had mild
limitations in understanding, remembering or applying information and adapting or
managing 	oneself 	and 	moderate 	limitations 	in 	interacting 	with 	others 	and
concentrating, persisting, or maintaining pace. (Id.) In so concluding, the ALJ cited
to benign objective examination findings and reports in the medical record that she
was capable of performing household tasks such as organizing and cleaning and was
able to care for and homeschool her children during the relevant period. (Id.)
Between Steps 3 and 4, the ALJ then fashioned a residual functional capacity
(“RFC”) for the plaintiff which considered all of her impairments as reflected in the
medical record, and found that:
After careful consideration of the entire record, I find that, through the
date last insured, the claimant had the residual functional capacity to
perform a full range of work at all exertional levels but with the
following nonexertional limitations: the claimant is able to perform
simple, routine, and repetitive tasks that are not at a production rate
pace (e.g., assembly line work). She can use judgement and deal with
changes consistent with this type of work. The claimant is able to
occasionally interact with supervisors and coworkers and never work
with the public.
(Tr. 22).
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In reaching this RFC, the ALJ considered her subjective statements regarding
her symptoms and cast them against the objective medical evidence. In her analysis,
the ALJ ultimately concluded that Danner’s “medically determinable impairments
could reasonably be expected to cause the alleged symptoms; however, the
statements of the claimant . . . 	concerning the intensity, persistence and limiting
effects of these symptoms are not entirely consistent with the medical evidence and
other evidence in the record.” (Tr. 23). The ALJ first summarized Danner’s
subjective statements about the limiting effects of her impairments, stating:
When she initially applied for benefits, the claimant alleged an inability
to work due to PTSD, severe depression, severe anxiety, ulcerative
colitis, irritable bowel syndrome, nightmares, sleep apnea, ADHD, and
Graves’ disease (Exhibit 1E/2). In a July 2022 Function Report, the
claimant reported that her impairments limit her ability to concentrate
on simple tasks, interact with others, and retain information (Exhibit
B4E/6). Furthermore, the claimant noted difficulties completing tasks,
remembering, and understanding (Id.). With regard to daily tasks, the
claimant 	indicated 	that 	she 	has 	difficulties 	preparing 	meals 	and
performing household tasks (Id. at 2-4). However, she also reported that
she is able to perform personal care items unassisted and shop for
household essentials via computer (Id.). She enjoys watching television,
playing electronic games on her phone, and socializing with others via
text or email (Id. at 5).
At the hearing, the claimant testified that she is currently forty-five and
married to Shawn Danner for twelve years. She lives with her husband
and her two children, Abigail, age ten, and Shawn Jr., age eleven. She
has a valid driver’s license but has not driven a motor vehicle for two
years.
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With regard to her functional limitations, the claimant testified that her
short-term memory is poor, and she has significant difficulties focusing.
She rarely leaves her home and has difficulties being around people. Her
husband performs most of the daily activities including shopping,
errands, cooking and housekeeping. The claimant lives in her pajamas
and showers infrequently.
(Id.)
The ALJ then observed that the extreme level of impairment alleged by
Danner was inconsistent with the objective record. At the outset, the ALJ determined
Danner’s treatment history did not support the extreme level of impairment which
she described. Instead, as the ALJ noted:
[T]he record shows that the claimant has often reported improvement
in response to her treatment. For example, at an October 2021 visit, the
claimant noted that she was “doing well” and reported that she was
taking her medications as prescribed and denied adverse side effects
(Exhibit B2F/11). Likewise, at visits during September 2022, the
claimant 	noted 	that 	her 	ADHD 	symptoms 	had 	improved 	on
dextroamphetamine and Vyvanse, and that her anxiety symptoms were
better on Xanax (Exhibit B8F/19, 22). Finally, at a November 2022
visit, 	the 	claimant 	noted 	that 	her 	attention, 	concentration, 	and
depression symptoms were all improving (Id. at 31). She denied manic
symptoms or psychosis but did report some situational stressors (Id.).
Likewise, in addition to these indications of subjective improvement,
the claimant has often demonstrated benign signs on mental status
examinations. For example, at a visit on May 16, 2020, the claimant
had cooperative behavior, normal speech, appropriate appearance,
intact orientation, intact memory, normal thought content, and adequate
concentration (Exhibit B1F/2). Likewise, the claimant demonstrated
similar 	signs 	on 	examinations 	performed 	during 	January 	2021,
December 2021, August 2022, and November 2022 (Exhibits B3F/27,
80 and B8F/11, 35). Finally, at an April 2023 visit, the claimant had
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cooperative behavior, normal speech, goal directed thought processes,
and grossly intact attention/concentration (Exhibit B10F/20).
(Tr. 23-24).
The ALJ also noted that, despite her claims of extreme limitations in her
activities of daily living, the record evidence showed she was more capable than she
alleged, noting:
Additionally, 	despite 	her 	testimony 	regarding 	severely 	limited
activities of daily living, the record suggests that she retains greater
functional abilities. First, in contrast to statements contained in her
Function Report, the claimant had often noted organizing, cleaning,
and performing other household tasks at her treatment visits (Exhibits
B1F/55 and B3F/142). Further, the records show that the claimant has
been very involved with her children and their homeschooling during
the 	relevant 	period 	(Exhibits 	B2F/27, 	B3F/119, 	and 	B8F/11).
Moreover, there are indications that the claimant enjoys following
organized sports and has attended minor league baseball games
(Exhibits B1F/73 and B8F/2, 13). Although the claimant testified that
she had to leave games early due to psychologically based symptoms
or 	triggers, 	this 	allegation 	is 	not 	reflected 	in 	contemporaneous
treatment notes.
(Tr. 24).
The ALJ also noted that Danner actually considered herself to be “retired” and
left the workforce for reasons not related to her medical impairments, specifically
referencing her ongoing EEO claim against her former employer. (Id.)
The ALJ then considered the meager medical opinion evidence in this case,
addressing the opinions of Dr. Fretz and Dr. Martin in a vague, cursory, and brief
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manner. The ALJ addressed these two opinions, which reached inconsistent
conclusions regarding the full limiting effects of Danner’s impairments, together as
one in a single paragraph finding both of the opinions “generally persuasive.” The
ALJ explained:
At the initial and reconsideration stages of the administrative process,
the psychological consultants who reviewed the file, Roger Fretz, PhD,
and Virginia Carolyn Martin, PsyD, opined that the claimant retained
the 	ability 	to 	perform 	simple 	tasks 	but 	would 	experience 	some
difficulties with social engagement, concentration, and learning new
material (Exhibits B3A and B6A). I find that these opinions continue
to be generally persuasive. Although these consultants are non-treating,
non-examining 	medical 	sources, the limitations 	outlined in 	these
opinions are supported by reference to the medical records available at
these 	prior 	stages 	(Exhibits 	B1F-B7F). 	Moreover, 	while 	these
consultants did not have the benefit of evidence received at the hearing
level, including testimony received at the hearing, these limitations
continue to be generally consistent with the evidence submitted at the
hearing level.
(Tr. 24-25). This analysis seemingly credited the consistent portions of these expert
opinions, that 	Danner could 	perform simple tasks with 	limitations 	in 	social
engagement, concentration, and learning new materials, but failed to acknowledge
or address the inconsistencies in these opinions, including the moderate limitations
opined by Dr. Fretz in the spheres of understanding, remembering, or applying
information and adapting or managing oneself and the opinion of Dr. Martin that
Danner could perform only one-to-two-step tasks.
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Having made these findings, the ALJ concluded that Danner could not
perform her past relevant work but that there were other jobs that existed in
significant numbers in the national economy that she could perform, including the
occupation of Marker that the VE identified as an occupation Danner could perform
even 	if limited 	to 	one-to-two-step 	tasks. 	(Tr. 26-27). 	Accordingly, 	the 	ALJ
concluded that Danner had not met the stringent standard of disability set by law and
denied this claim. (Id.)
This appeal followed. (Doc. 1). On appeal, Danner asserts a two-fold
argument attacking both the ALJ’s symptom evaluation and consideration of the
medical opinion evidence in this case. These issues are fully briefed by the parties
and are, therefore, ripe for resolution.
Upon consideration, we find that the ALJ’s assessment of Danner’s symptoms
was supported by substantial evidence. Further, while we agree with the plaintiff that
the ALJ’s assessment of the medical opinion evidence in this case was deficient, any
error was harmless. Accordingly, we will affirm the decision of the Commissioner.
III. 	Discussion
A. Substantial Evidence Review – the Role of this Court
When reviewing the Commissioner’s final decision denying a claimant’s
application for benefits, this Court’s review is limited to the question of whether the
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findings of the final decision-maker are supported by substantial evidence in the
record. 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).
Substantial evidence “does not mean a large or considerable amount of evidence, but
rather such relevant evidence as a reasonable mind might accept as adequate to
support a conclusion.” Pierce v. Underwood, 487 U.S. 552, 565 (1988). Substantial
evidence is less than a preponderance of the evidence but more than a mere scintilla.
Richardson v. Perales, 402 U.S. 389, 401 (1971). A single piece of evidence is not
substantial evidence if the ALJ ignores countervailing evidence or fails to resolve a
conflict created by the evidence. Mason v. Shalala, 994 F.2d 1058, 1064 (3d Cir.
1993). But in 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.” Consolo v. Fed. Maritime Comm’n,
383 U.S. 607, 620 (1966). “In determining if the Commissioner’s decision is
supported by substantial evidence the court must scrutinize the record as a whole.”
Leslie v. Barnhart, 304 F. Supp. 2d 623, 627 (M.D. Pa. 2003).
The Supreme Court has recently underscored for us the limited scope of our
review in this field, noting that:
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The phrase “substantial evidence” is a “term of art” used throughout
administrative law to describe how courts are to review agency
factfinding. T-Mobile South, LLC v. Roswell, 574 U.S. ––––, ––––,
135 S.Ct. 808, 815, 190 L.Ed.2d 679 (2015). Under the substantial-
evidence standard, a court looks to an existing administrative record
and asks whether it contains “sufficien[t] evidence” to support the
agency’s factual determinations. Consolidated Edison Co. v. NLRB,
305 U.S. 197, 229, 59 S.Ct. 206, 83 L.Ed. 126 (1938) (emphasis
deleted). And whatever the meaning of “substantial” in other contexts,
the threshold for such evidentiary sufficiency is not high. Substantial
evidence, this Court has said, is “more than a mere scintilla.” Ibid.; see,
e.g., Perales, 402 U.S. at 401, 91 S.Ct. 1420 (internal quotation marks
omitted). It means—and means only—“such relevant evidence as a
reasonable mind might accept as adequate to support a conclusion.”
Consolidated Edison, 305 U.S. at 229, 59 S.Ct. 206. See Dickinson v.
Zurko, 527 U.S. 150, 153, 119 S.Ct. 1816, 144 L.Ed.2d 143 (1999)
(comparing the substantial-evidence standard to the deferential clearly-
erroneous standard).
Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019).
The question before this Court, therefore, is not whether the claimant is
disabled, but rather whether the Commissioner’s finding that she is not disabled is
supported by substantial evidence and was reached based upon a correct application
of the relevant law. 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
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matters is plenary); Ficca, 901 F. Supp. 2d at 536 (“[T]he court has plenary review
of all legal issues . . . .”).
Several fundamental legal propositions flow from this deferential standard of
review. First, when conducting this review, “we are mindful that we must not
substitute our own judgment for that of the fact finder.” Zirnsak v. Colvin, 777 F.3d
607, 611 (3d Cir. 2014) (citing Rutherford, 399 F.3d at 552). Thus, we are enjoined
to refrain from trying to re-weigh the evidence. Rather, our task is to simply
determine whether substantial evidence supported the ALJ’s findings. However, we
must also ascertain whether the ALJ’s decision meets the burden of articulation
demanded by the courts to enable informed judicial review. Simply put, “this Court
requires the ALJ to set forth the reasons for his decision.” Burnett v. Comm’r of Soc.
Sec. Admin., 220 F.3d 112, 119 (3d Cir. 2000). As the Court of Appeals has noted
on this score:
In Burnett, we held that an ALJ must clearly set forth the reasons for
his 	decision. 	220 	F.3d 	at 	119. 	Conclusory 	statements 	. 	. 	. 	are
insufficient. The ALJ must provide a “discussion of the evidence” and
an “explanation of reasoning” for his conclusion sufficient to enable
meaningful judicial review. Id. at 120; see Jones v. Barnhart, 364 F.3d
501, 505 & n. 3 (3d Cir. 2004). The ALJ, of course, need not employ
particular “magic” words: “Burnett does not require the ALJ to use
particular language or adhere to a particular format in conducting his
analysis.” Jones, 364 F.3d at 505.
Diaz v. Comm’r of Soc. Sec., 577 F.3d 500, 504 (3d Cir. 2009).
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Thus, in practice, ours is a twofold task. We must evaluate the substance of
the ALJ’s decision under a deferential standard of review, but we must also give that
decision careful scrutiny to ensure that the rationale for the ALJ’s actions is
sufficiently articulated to permit meaningful judicial review.
This principle applies with particular force to legal challenges, like the claim
made here, based upon alleged inadequacies in the articulation of a claimant’s
mental RFC. In Hess v. Comm’r Soc. Sec., 931 F.3d 198, 212 (3d Cir. 2019), the
United States Court of Appeals recently addressed the standards of articulation that
apply in this setting. In Hess the court of appeals considered the question of whether
an RFC which limited a claimant to simple tasks adequately addressed moderate
limitations on concentration, persistence, and pace. In addressing the plaintiff’s
argument that the language used by the ALJ to describe the claimant’s mental
limitations was legally insufficient, the court of appeals rejected a per se rule which
would require the ALJ to adhere to a particular format in conducting this analysis.
Instead, framing this issue as a question of adequate articulation of the ALJ’s
rationale, the court held that: “as long as the ALJ offers a ‘valid explanation,’ a
‘simple tasks’ limitation is permitted after a finding that a claimant has ‘moderate’
difficulties in ‘concentration, persistence, or pace.’ ” Hess v. Comm’r Soc. Sec., 931
F.3d 198, 211 (3d Cir. 2019). On this score, the appellate court indicated that an ALJ
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offers a valid explanation a mental RFC when the ALJ highlights factors such as
“mental status examinations and reports that revealed that [the claimant] could
function effectively; opinion evidence showing that [the claimant] could do simple
work; and [the claimant]’s activities of daily living, . . . . ” Hess v. Comm’r Soc.
Sec., 931 F.3d 198, 214 (3d Cir. 2019).
In our view, the teachings of the Hess decision are straightforward. In
formulating a mental RFC the ALJ does not need to rely upon any particular form
of words. Further, the adequacy of the mental RFC is not gauged in the abstract.
Instead, the evaluation of a claimant’s ability to undertake the mental demands of
the workplace will be viewed in the factual context of the case, and a mental RFC is
sufficient if it is supported by a valid explanation grounded in the evidence.
B. Initial Burdens of Proof, Persuasion, and Articulation for the ALJ
To receive benefits under the Social Security Act by reason of disability, a
claimant must demonstrate an 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 20
C.F.R. §404.1505(a). To satisfy this requirement, a claimant must have a severe
physical or mental impairment that makes it impossible to do his or her previous
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work or any other substantial gainful activity that exists in the national economy. 42
U.S.C. §423(d)(2)(A); 20 C.F.R. §404.1505(a). To receive benefits under Title II of
the Social Security Act, a claimant must show that he or she contributed to the
insurance program, is under retirement age, and became disabled prior to the date on
which he or she was last insured. 42 U.S.C. §423(a); 20 C.F.R. §404.131(a).
In making this determination at the administrative level, the ALJ follows a
five-step sequential evaluation process. 20 C.F.R. §404.1520(a). Under this process,
the ALJ must sequentially determine: (1) whether the claimant is engaged in
substantial gainful activity; (2) whether the claimant has a severe impairment; (3)
whether the claimant’s impairment meets or equals a listed impairment; (4) whether
the claimant is able to do his or her past relevant work; and (5) whether the claimant
is able to do any other work, considering his or her age, education, work experience
and residual functional capacity (“RFC”). 20 C.F.R. §404.1520(a)(4).
Between Steps 3 and 4, the ALJ must also assess a 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).” Burnett v. Comm’r
of Soc. Sec., 220 F.3d 112, 121 (3d Cir. 2000) (citations omitted); see also 20 C.F.R.
§§404.1520(e), 404.1545(a)(1). In making this assessment, the ALJ considers all of
the claimant’s medically determinable impairments, including any non-severe
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impairments identified by the ALJ at step two of his or her analysis. 20 C.F.R.
§404.1545(a)(2).
There is an undeniable medical aspect to an RFC determination, since that
determination entails an assessment of what work the claimant can do given the
physical limitations that the claimant experiences. Yet, when considering the role
and necessity of medical opinion evidence in making this determination, courts have
followed several different paths. Some courts emphasize the importance of medical
opinion support for an RFC determination and have suggested that “[r]arely can a
decision be made regarding a claimant’s residual functional capacity without an
assessment from a physician regarding the functional abilities of the claimant.”
Biller v. Acting Comm’r of Soc. Sec., 962 F. Supp. 2d 761, 778–79 (W.D. Pa. 2013)
(quoting Gormont v. Astrue, Civ. No. 11–2145, 2013 WL 791455 at *7 (M.D. Pa.
Mar. 4, 2013)). In other instances, it has been held that: “There is no legal
requirement that a physician have made the particular findings that an ALJ adopts
in the course of determining an RFC.” Titterington v. Barnhart, 174 F. App’x 6, 11
(3d Cir. 2006). Further, courts have held in cases where there is no evidence of any
credible medical opinion supporting a claimant’s allegations of disability that “the
proposition that an ALJ must always base his RFC on a medical opinion from a
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physician is misguided.” Cummings v. Colvin, 129 F. Supp. 3d 209, 214–15 (W.D.
Pa. 2015).
These 	seemingly 	discordant 	legal 	propositions 	can 	be 	reconciled 	by
evaluation of the factual context of these decisions. Those cases which emphasize
the importance of medical opinion support for an RFC assessment typically arise in
the factual setting where a well-supported medical source has identified limitations
that would support a disability claim, but an ALJ has rejected the medical opinion
which supported a disability determination based upon a lay assessment of other
evidence. Biller, 962 F.Supp.2d at 778–79. In this setting, these cases simply restate
the commonplace idea that medical opinions are entitled to careful consideration
when making a disability determination, particularly when those opinions support a
finding of disability. In contrast, when an ALJ is relying upon other evidence, such
as contrasting clinical or opinion evidence or testimony regarding the claimant’s
activities of daily living, to fashion an RFC courts have adopted a more pragmatic
view and have sustained the ALJ’s exercise of independent judgment based upon all
of the facts and evidence. See Titterington v. Barnhart, 174 F. App’x 6, 11 (3d Cir.
2006); Cummings v. Colvin, 129 F. Supp. 3d 209, 214–15 (W.D. Pa. 2015). In either
event, once the ALJ has made this determination, our review of the ALJ’s assessment
of the plaintiff’s RFC is deferential, and that RFC assessment will not be set aside if
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it is supported by substantial evidence. Burns v. Barnhart, 312 F.3d 113, 129 (3d
Cir. 2002); see also Metzger v. Berryhill, No. 3:16-CV-1929, 2017 WL 1483328, at
*5 (M.D. Pa. Mar. 29, 2017), report and recommendation adopted sub nom. Metzgar
v. Colvin, No. 3:16-CV-1929, 2017 WL 1479426 (M.D. Pa. Apr. 21, 2017); Rathbun
v. Berryhill, No. 3:17-CV-00301, 2018 WL 1514383, at *6 (M.D. Pa. Mar. 12,
2018), report and recommendation adopted, No. 3:17-CV-301, 2018 WL 1479366
(M.D. Pa. Mar. 27, 2018).
At Steps 1 through 4, the claimant bears the initial burden of demonstrating
the existence of a medically determinable impairment that prevents him or her in
engaging in any of his or her past relevant work. Mason, 994 F.2d at 1064. Once this
burden has been met by the claimant, it shifts to the Commissioner at Step 5 to show
that jobs exist in significant number in the national economy that the claimant could
perform that are consistent with the claimant’s age, education, work experience and
RFC. 20 C.F.R. §404.1512(f); Mason, 994 F.2d at 1064.
The ALJ’s disability determination must also meet certain basic substantive
requisites. Most significant among these legal benchmarks is a requirement that the
ALJ adequately explain the legal and factual basis for this disability determination.
Thus, in order to facilitate review of the decision under the substantial evidence
standard, the ALJ’s decision must be accompanied by “a clear and satisfactory
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explication of the basis on which it rests.” Cotter v. Harris, 642 F.2d 700, 704 (3d
Cir. 1981). Conflicts in the evidence must be resolved and the ALJ must indicate
which evidence was accepted, which evidence was rejected, and the reasons for
rejecting certain evidence. Id. at 706-07. In addition, “[t]he ALJ must indicate in his
decision which evidence he has rejected and which he is relying on as the basis for
his finding.” Schaudeck v. Comm’r of Soc. Sec., 181 F.3d 429, 433 (3d Cir. 1999).
C. Legal Benchmarks for the ALJ’s Assessment of a Claimant’s Alleged
Symptoms
The interplay between the deferential substantive standard of review that
governs Social Security appeals, and the requirement that courts carefully assess
whether an ALJ has met the standards of articulation required by law, is illustrated
by those cases which consider analysis of a claimant’s reported symptoms. When
evaluating lay testimony regarding a claimant’s reported symptoms we are reminded
that:
[T]he ALJ must necessarily make certain credibility determinations,
and this Court defers to the ALJ's assessment of credibility. See Diaz v.
Comm'r, 577 F.3d 500, 506 (3d Cir.2009) (“In determining whether
there is substantial evidence to support an administrative law judge's
decision, we owe deference to his evaluation of the evidence [and]
assessment of the credibility of witnesses....”). However, the ALJ must
specifically identify and explain what evidence he found not credible
and why he found it not credible. Adorno v. Shalala, 40 F.3d 43, 48 (3d
Cir.1994) (citing Stewart v. Sec'y of Health, Education and Welfare,
714 F.2d 287, 290 (3d Cir.1983)); see also Stout v. Comm'r, 454 F.3d
1050, 1054 (9th Cir.2006) (stating that an ALJ is required to provide
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“specific reasons for rejecting lay testimony”). An ALJ cannot reject
evidence for an incorrect or unsupported reason. Ray v. Astrue, 649
F.Supp.2d 391, 402 (E.D.Pa.2009) (quoting Mason v. Shalala, 994 F.2d
1058, 1066 (3d Cir.1993)).
Zirnsak v. Colvin, 777 F.3d 607, 612–13 (3d Cir. 2014).
Yet, it is also clear that:
Great weight is given to a claimant's subjective testimony only when it
is supported by competent medical evidence. Dobrowolsky v. Califano,
606 F.2d 403, 409 (3d Cir. 1979); accord Snedeker v. Comm'r of Soc.
Sec., 244 Fed.Appx. 470, 474 (3d Cir. 2007). An ALJ may reject a
claimant's subjective testimony that is not found credible so long as
there is an explanation for the rejection of the testimony. Social
Security Ruling (“SSR”) 96–7p; Schaudeck v. Comm'r of Social
Security, 181 F.3d 429, 433 (3d Cir. 1999). Where an ALJ finds that
there is an underlying medically determinable physical or mental
impairment 	that 	could 	reasonably 	be 	expected 	to 	produce 	the
individual's pain or other symptoms, however, the severity of which is
not substantiated by objective medical evidence, the ALJ must make a
finding on the credibility of the individual's statements based on a
consideration of the entire case record.
McKean v. Colvin, 150 F. Supp. 3d 406, 415–16 (M.D. Pa. 2015)(footnotes
omitted). Thus, we are instructed to review an ALJ’s evaluation of a claimant’s
subjective reports of pain under a standard of review which is deferential with
respect to the ALJ’s well-articulated findings but imposes a duty of clear articulation
upon the ALJ so that we may conduct meaningful review of the ALJ’s conclusions.
In the same fashion that medical opinion evidence is evaluated, the Social
Security Rulings and Regulations provide a framework under which the severity of
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a claimant's reported symptoms are to be considered. 20 C.F.R. §§ 404.1529,
416.929; SSR 16–3p. It is important to note that though the “statements of the
individual concerning his or her symptoms must be carefully considered, the ALJ is
not required to credit them.” 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.”). It is well-settled in
the Third Circuit that “[a]llegations of pain and other subjective symptoms must be
supported by objective medical evidence.” Hantraft v. Apfel, 181 F.3d 358, 362 (3d
Cir. 1999) (referring to 20 C.F.R. §404.1529). When evaluating a claimant’s
symptoms, the ALJ must follow a two-step process in which the ALJ resolves
whether a medically determinable impairment could be the cause of the symptoms
alleged by the claimant and subsequently must evaluate the alleged symptoms in
consideration of the record as a whole. SSR 16-3p.
First, symptoms, such as pain or fatigue, will only be considered to affect a
claimant's ability to perform work activities if such symptoms result from an
underlying physical or mental impairment that has been demonstrated to exist by
medical signs or laboratory findings. 20 C.F.R. §§ 404.1529(b), 416.929(b); SSR
16–3p. During the second step of this credibility assessment, the ALJ must determine
whether the claimant's statements about the intensity, persistence or functionally
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limiting effects of his or her symptoms are substantiated based on the ALJ's
evaluation of the entire case record. 20 C.F.R. § 404.1529(c), 416.929(c); SSR 16–
3p. This includes but is not limited to medical signs and laboratory findings,
diagnosis and other medical opinions provided by treating or examining sources, and
other medical sources, as well as information concerning the claimant's symptoms
and how they affect his or her ability to work. Id. The Social Security Administration
has recognized that individuals may experience their symptoms differently and may
be limited by their symptoms to a greater or lesser extent than other individuals with
the same medical impairments, signs, and laboratory findings. SSR 16–3p.
Thus, to assist in the evaluation of a claimant's subjective symptoms, the
Social Security Regulations identify seven factors which may be relevant to the
assessment of the severity or limiting effects of a claimant's impairment based on a
claimant's symptoms. 20 C.F.R. §§ 404.1529(c)(3), 416.929(c)(3). These factors
include: activities of daily living; the location, duration, frequency, and intensity of
the claimant's symptoms; precipitating and aggravating factors; the type, dosage,
effectiveness, and side effects of any medication the claimant takes or has taken to
alleviate his or her symptoms; treatment, other than medication that a claimant has
received for relief; any measures the claimant has used to relieve his or her
symptoms; and, any other factors concerning the claimant's functional limitations
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and restrictions. Id.; see George v. Colvin, No. 4:13–CV–2803, 2014 WL 5449706,
at *4 (M.D.Pa. Oct. 24, 2014); Koppenaver v. Berryhill, No. 3:18-CV-1525, 2019
WL 1995999, at *9 (M.D. Pa. Apr. 8, 2019), report and recommendation adopted
sub nom. Koppenhaver v. Berryhill, No. 3:18-CV-1525, 2019 WL 1992130 (M.D.
Pa. May 6, 2019); Martinez v. Colvin, No. 3:14-CV-1090, 2015 WL 5781202, at
*8–9 (M.D. Pa. Sept. 30, 2015).
D. Legal Benchmarks for the ALJ’s Assessment of Medical Opinions
The plaintiff filed this disability application following a paradigm shift in the
manner in which medical opinions were evaluated when assessing Social Security
claims. Prior to March 2017, ALJs were required to follow regulations which defined
medical opinions narrowly and created a hierarchy of medical source opinions with
treating sources at the apex of this hierarchy. However, in March of 2017, the
Commissioner’s regulations governing medical opinions changed in a number of
fundamental ways. The range of opinions that ALJs were enjoined to consider were
broadened substantially, and the approach to evaluating opinions was changed from
a hierarchical form of review to a more holistic analysis. As one court as aptly
observed:
The regulations regarding the evaluation of medical evidence have been
amended for claims filed after March 27, 2017, and several of the prior
Social Security Rulings, including SSR 96-2p, have been rescinded.
According to the new regulations, the Commissioner “will no longer
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give any specific evidentiary weight to medical opinions; this includes
giving controlling weight to any medical opinion.” Revisions to Rules
Regarding the Evaluation of Medical Evidence (“Revisions to Rules”),
2017 WL 168819, 82 Fed. Reg. 5844, at 5867–68 (Jan. 18, 2017), see
20 C.F.R. §§ 404.1520c(a), 416.920c(a). Instead, the Commissioner
must consider all medical opinions and “evaluate their persuasiveness”
based 	on 	the 	following 	five 	factors: 	supportability; 	consistency;
relationship with the claimant; specialization; and “other factors.” 20
C.F.R. §§ 404.1520c(a)-(c), 416.920c(a)-(c).
Although the new regulations eliminate the perceived hierarchy of
medical sources, deference to specific medical opinions, and assigning
“weight” to a medical opinion, the ALJ must still “articulate how [he
or she] considered the medical opinions” and “how persuasive [he or
she] find[s] all of the medical opinions.” Id. at §§ 404.1520c(a) and
(b)(1), 416.920c(a) and (b)(1). The two “most important factors for
determining the persuasiveness of medical opinions are consistency and
supportability,” 	which 	are 	the 	“same 	factors” 	that 	formed 	the
foundation of the treating source rule. Revisions to Rules, 82 Fed. Reg.
5844-01 at 5853.
An ALJ is specifically required to “explain how [he or she] considered
the supportability and consistency factors” for a medical opinion. 20
C.F.R. 	§§ 	404.1520c 	(b)(2), 	416.920c(b)(2). 	With 	respect 	to
“supportability,” the new regulations provide that “[t]he more relevant
the objective medical evidence and supporting explanations presented
by a medical source are to support his or her medical opinion(s) or prior
administrative medical finding(s), the more persuasive the medical
opinions or prior administrative medical finding(s) will be.” Id. at §§
404.1520c(c)(1), 416.920c(c)(1). The regulations provide that with
respect to “consistency,” “[t]he more consistent a medical opinion(s) or
prior administrative medical finding(s) is with the evidence from other
medical sources and nonmedical sources in the claim, the more
persuasive the medical opinion(s) or prior administrative medical
finding(s) will be.” Id. at §§ 404.1520c(c)(2), 416.920c(c)(2).
Under the new regulations an ALJ must consider, but need not
explicitly discuss, the three remaining factors in determining the
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persuasiveness of a medical source's opinion. Id. at §§ 404.1520c(b)(2),
416.920c(b)(2). However, where the ALJ has found two or more
medical opinions to be equally well supported and consistent with the
record, but not exactly the same, the ALJ must articulate how he or she
considered those factors contained in paragraphs (c)(3) through (c)(5).
Id. at §§ 404.1520c(b)(3), 416.920c(b)(3).
Andrew G. v. Comm'r of Soc. Sec., No. 3:19-CV-0942 (ML), 2020 WL 5848776, at
*5 (N.D.N.Y. Oct. 1, 2020).
Oftentimes, as in this case, an ALJ must evaluate various medical opinions.
When presented with a disputed factual record, it is well-established that “[t]he ALJ
– not treating or examining physicians or State agency consultants – must make the
ultimate disability and RFC determinations.” Chandler v. Comm’r of Soc. Sec., 667
F.3d 356, 361 (3d Cir. 2011). However, the ALJ must still fully articulate the basis
of this medical opinion evaluation. Thus, when evaluating medical opinions “the
ALJ may choose whom to credit but ‘cannot reject evidence for no reason or for the
wrong reason.’” Morales v. Apfel, 225 F.3d 310, 317 (3d Cir. 2000) (quoting Mason,
994 F.2d at 1066). It also follows that “when a medical opinion is found persuasive
and contains a limitation to one- and two-step tasks, the ALJ is obligated to either:
(1) include the limitation in the RFC and limit the claimant to reasoning level one
occupations, or, (2) identify the substantial evidence that the ALJ is relying on in
rejecting the limitation.” Cruz, 2025 WL 2813882, at *8.
These legal benchmarks guide us in the instant case.
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D. The Commissioner’s Decision Will Be Affirmed.
1. The ALJ’s Evaluation of the Plaintiff’s Symptoms was Supported
by Substantial Evidence.
In the instant case, Danner first invites us to set aside an ALJ’s findings
concerning the severity of her symptoms resulting from her mental impairments. In
considering Danner’s arguments, we are mindful that we are not free to substitute
our independent assessment of the evidence for the ALJ’s determinations. Rather,
we must simply ascertain whether the ALJ’s decision is supported by substantial
evidence, a quantum of proof which is less than a preponderance of the evidence but
more than a mere scintilla, Richardson, 402 U.S. at 401, and “does not mean a large
or considerable amount of evidence, but rather such relevant evidence as a
reasonable mind might accept as adequate to support a conclusion.” Pierce, 487 U.S.
at 565. Judged against these deferential standards of review, we find that substantial
evidence supported the ALJ’s evaluation of Danner’s symptoms.
Danner argues that the ALJ’s evaluation of her subjective symptoms was
flawed and the ALJ’s conclusion that her statements were not entirely consistent
with the medical evidence was not supported by substantial evidence. However, our
review of the ALJ’s decision and the record as a whole reveals that the ALJ’s
evaluation of her symptoms complied with the regulations. On this score, while the
plaintiff challenges the ALJ’s reliance on her activities of daily living and benign
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objective examination 	findings in 	assessing 	her subjective reports, these are
precisely the types of factors the ALJ is empowered to explore in this evaluation.
Moreover, our review of the record reveals substantial evidence supported the
conclusions of the ALJ. At the outset, the ALJ noted that Danner’s reported
symptoms are at odds with the consistently benign mental status evaluations. In our
view, the records of Dr. Turk we summarized above support this view, since during
the relevant period her mental examinations were regularly normal, showing intact
attention span and concentration, cooperative attitude, and anxiety symptoms
lessening and bipolar improving overall. (Tr. 784, 797, 800, 806, 810, 819, 825, 828,
837, 840, 843, 846, 849, 855, 857, 863, 869).
Further, the ALJ stated that:
[D]espite her testimony regarding severely limited activities of daily
living, the record suggests that she retains greater functional abilities.
First, in contrast to statements contained in her Function Report, the
claimant had often noted organizing, cleaning, and performing other
household tasks at her treatment visits (Exhibits B1F/55 and B3F/142).
Further, the records show that the claimant has been very involved with
her children and their homeschooling during the relevant period
(Exhibits 	B2F/27, 	B3F/119, 	and 	B8F/11). 	Moreover, 	there 	are
indications that the claimant enjoys following organized sports and has
attended minor league baseball games (Exhibits B1F/73 and B8F/2,
13). Although the claimant testified that she had to leave games early
due to psychologically based symptoms or triggers, this allegation is
not reflected in contemporaneous treatment notes.
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(Tr. 24). Despite the plaintiff’s arguments to the contrary, upon review, the medical
records do reveal that Danner was able to visit with family and friends for holidays,
attend a birthday party, interact with neighbors, and homeschool her children. (Tr.
783, 802, 808, 839, 856, 955).
Further, while we recognize that the ALJ could not rely upon periods of
improvement in her symptoms to wholly reject her subjective complaints, see
Garrison v. Colvin, 759 F.3d 995, 1017 (9th Cir. 2014) (“[W]hile discussing mental
health issues, it is error to reject a claimant's testimony merely because symptoms
wax and wane in the course of treatment”), the effectiveness of medication and
treatment are relevant factors to the symptom analysis. On this score, the ALJ noted:
[T]he record shows that the claimant has often reported improvement in
response to her treatment. For example, at an October 2021 visit, the
claimant noted that she was “doing well” and reported that she was
taking her medications as prescribed and denied adverse side effects
(Exhibit B2F/11). Likewise, at visits during September 2022, the
claimant 	noted 	that 	her 	ADHD 	symptoms 	had 	improved 	on
dextroamphetamine and Vyvanse, and that her anxiety symptoms were
better on Xanax (Exhibit B8F/19, 22). Finally, at a November 2022 visit,
the claimant noted that her attention, concentration, and depression
symptoms were all improving (Id. at 31). She denied manic symptoms
or psychosis but did report some situational stressors (Id.).
(Tr. 23-24). Substantial evidence supports the ALJ’s conclusion that her symptoms
were improving, since Dr. Turk’s records indicate periods of improvement with
better and worse days through the end of 2022 with examination notes remaining
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relatively unremarkable, (tr. 917-58), and by the end of the relevant period, Dr. Turk
noted she was handling triggers to anxiety and panic better and that her attention,
concentration, and depression symptoms were ongoing but improving. (Tr. 949).
Thus, the effectiveness of her treatment was squarely before the ALJ and a relevant
consideration in this analysis.
As to the plaintiff’s argument that the ALJ improperly indicated that she
separated from her employment for non-medical reasons by highlighting her
retirement and the existence of the EEO complaint, the ALJ considered this in the
context of the credibility of the claimant. As the ALJ explained:
Further, the record documents several items that call into question the
veracity of the claimant’s allegations. Most notably, the claimant
testified that she discontinued working as a corrections officer on
October 31, 2016, for reasons not related to her medical impairments.
Consistent with her testimony, her medical records contain frequent
references to the progress of her EEO claim (Exhibits B1F/13, 89 and
B3F/107). At the same time, the claimant has often described herself as
“retired” at treatment visits (Exhibits B2F/25, 27 and B3F/67).
(Tr. 24). While the plaintiff’s argument is that the existence of the EEO claim should
have only bolstered her allegations of symptoms from PTSD, “as a legal matter
“[t]he ALJ, ..., ‘has the right, as the fact finder, to reject partially, or even entirely,
[a claimant's statements] if they are not fully credible.” Love v. Astrue, No. 1:12-
CV-1923, 2014 WL 4915998, at *9 (M.D. Pa. Sept. 30, 2014) (quoting Schuster v.
Astrue, 879 F.Supp.2d 461, 470 (E.D.Pa.2012)) (internal quotation omitted). In our
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view, whether the claimant left her employment for medical or other reasons is
relevant to this credibility determination. Indeed, Danner testified that she was
medically retired from USP Lewisburg at least in part due to trauma resulting from
sexual harassment and discrimination she faced there. (Tr. 41-42). Thus, while the
ALJ did not reject her statements about her symptoms for this reason alone, there
was 	no 	error 	in 	considering 	the 	circumstances 	surrounding 	the 	end 	of 	her
employment in assessing the overall credibility of her statements.
Simply put, the plaintiff’s attack on the ALJ’s symptom analysis is, at bottom,
a request that this court re-weigh the evidence. This we may not do. See Chandler,
667 F.3d at 359 (citing Richardson v. Perales, 402 U.S. 389, 401 (1971) (“Courts are
not permitted to re-weigh the evidence or impose their own factual determinations”);
see also Gonzalez v. Astrue, 537 F.Supp.2d 644, 657 (D. Del. 2008) (“In determining
whether substantial evidence supports the Commissioner’s findings, the Court may
not undertake a de novo review of the Commissioner’s decision and may not re-
weigh the evidence of the record”) (internal citations omitted)). Rather, our task is
simply to determine whether the ALJ’s decision is supported by substantial
evidence, a quantum of proof which is less than a preponderance of the evidence but
more than a mere scintilla, Richardson, 402 U.S. at 401, and “does not mean a large
or considerable amount of evidence, but rather such relevant evidence as a
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reasonable mind might accept as adequate to support a conclusion.” Pierce, 487 U.S.
at 565. Finding that this deferential standard of review is met here, we conclude there
was no error in the ALJ’s evaluation of Danner’s symptoms.
2. The ALJ’s Assessment of the Opinion Evidence was Deficient, but
the Error Was Harmless.
We next turn to the plaintiff’s argument that the ALJ’s assessment of the
medical opinion evidence was error. As we prefaced above, we agree that the ALJ’s
brief, cursory treatment of the opinions of these two State agency experts failed in
some narrow respects to meet the articulation standards required by the regulations.
In reaching this conclusion we find ourselves at the intersection between two well-
settled paradigms in the Social Security field. First, our highly deferential standard
of review empowers “[t]he ALJ – not treating or examining physicians or State
agency consultants – [to] make the ultimate disability and RFC determinations.”
Chandler, 667 F.3d at 361. Thus, our decision in this case in no way undercuts the
legal tenet that an ALJ is not required to adopt every limitation opined by the experts
but “can formulate an RFC based on different parts from the different medical
opinions.” Durden, 191 F.Supp.3d at 455. However, at base, an ALJ must draft a
reviewable opinion that is grounded in the evidence and provides the court with an
adequately articulated and well-reasoned rationale for the limitations adopted.
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Here, the brief, cursory manner in which the ALJ addressed these two medical
opinions fails to meet this basic standard of articulation for at least two reasons. First,
in addressing these two opinions together in a single paragraph the ALJ failed to
acknowledge or 	address 	the 	inconsistencies 	in 	these 	opinions, 	including 	the
moderate 	limitations 	opined 	by 	Dr. 	Fretz 	in 	the 	spheres 	of 	understanding,
remembering, or applying information and adapting or managing oneself and the
opinion of Dr. Martin that Danner could perform only one-to-two-step tasks. Thus,
the portions of each opinion the ALJ concluded were “generally persuasive” is
unexplained. In our view, it was error for the ALJ to address the two State agency
opinions, which reached inconsistent conclusions regarding the severity of the
limitations posed by Danner’s impairments, as one and conclude vaguely and
summarily that these opinions were “generally persuasive” without explaining
which parts of these inconsistent opinions were persuasive and which were not.
Moreover, in the past we have repeatedly concluded that “when a medical
opinion is found persuasive and contains a limitation to one- and two-step tasks, the
ALJ is obligated to either: (1) include the limitation in the RFC and limit the claimant
to reasoning level one occupations, or, (2) identify the substantial evidence that the
ALJ is relying on in rejecting the limitation.” Cruz, 2025 WL 2813882, at *8. See
also Whitney v. Bisignano, No. 4:24-CV-1950, 2026 WL 522922, at *10 (M.D. Pa.
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Feb. 25, 2026); 	Cruz v. Bisignano, No. 1:24-CV-1966, 2025 WL 2813882, at *7
(M.D. Pa. Sept. 30, 2025); Michelle M. v. Bisignano, No. 3:23-CV-02163, 2025 WL
2713737, at *7 (M.D. Pa. Sept. 23, 2025); Warren v. Dudek, No. 1:24-CV-635, 2025
WL 1168276, at *6 (M.D. Pa. Apr. 22, 2025); Shipman v. Kizakazi, No. 3:22-CV-
00636, 2023 WL 5599607, at *10 (M.D. Pa. Aug. 29, 2023). Here, the ALJ
seemingly adopted the opinion of Dr. Martin, finding Danner experienced mild to
moderate limitations in functioning, but failed to address or acknowledge Dr.
Martin’s statement that Danner could perform only one-to-two-step tasks. This was
error.
However, we are enjoined to refrain from viewing these deficiencies in the
abstract. Rather any errors in ALJ analysis must be considered in the factual context
of the case and are subject to harmless error analysis. Thus:
[A]ny 	evaluation 	of 	an 	administrative 	agency 	disability
determination must also take into account the fundamental
principle that: “ ‘No principle of administrative law or common
sense requires us to remand a case in quest of a perfect opinion
unless there is reason to believe that the remand might lead to a
different result.’ ” Moua v. Colvin, 541 Fed.Appx. 794, 798
(10th Cir. 2013) quoting Fisher v. Bowen, 869 F.2d 1055, 1057
(7th Cir. 1989). Thus, ALJ determinations in Social Security
appeals are subject to harmless error analysis, Seaman v. Soc.
Sec. Admin., 321 Fed.Appx. 134, 135 (3d Cir. 2009) and “the
burden of showing that an error is harmful normally falls upon
the party attacking the agency's determination.” Shinseki v.
Sanders, 556 U.S. 396, 409, 129 S. Ct. 1696, 1706, 173 L.Ed.
2d 532 (2009).
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Metzger v. Berryhill, No. 3:16-CV-1929, 2017 WL 1483328, at *4
(M.D. Pa. Mar. 29, 2017), report and recommendation adopted sub
nom. Metzgar v. Colvin, No. 3:16-CV-1929, 2017 WL 1479426 (M.D.
Pa. Apr. 21, 2017).
In this regard “we apply harmless error analysis cautiously in the
administrative review setting.” Fischer–Ross v. Barnhart, 431 F.3d 729,
733 (10th Cir. 2005). However:
In Social Security appeals courts may apply harmless error
analysis when assessing the sufficiency of an ALJ's decision.
Seaman v. Soc. Sec. Admin., 321 Fed.Appx. 134, 135 (3d Cir.
2009). “Under the harmless error rule, an error warrants remand
if it prejudices a party's ‘substantial rights.’ An error implicates
substantial 	rights 	if 	it 	likely 	affects 	the 	outcome 	of 	the
proceeding, or likely affects the ‘perceived fairness, integrity,
or public reputation of judicial proceedings.’ ” Hyer v. Colvin,
72 F. Supp. 3d 479, 494 (D. Del. 2014).
Harrison v. Berryhill, No. 3:17-CV-618, 2018 WL 2051691, at *5
(M.D. Pa. Apr. 17, 2018), report and recommendation adopted, No.
3:17-CV-0618, 2018 WL 2049924 (M.D. Pa. May 2, 2018).
Drozd v. Kizakaji, No. 1:21-CV-2063, 2023 WL 122387, at *11 (M.D. Pa. Jan. 6,
2023).
In this case, while we find that Danner has identified an ALJ error in failing
to more clearly articulate which portions of the medical opinion evidence were
persuasive and in failing to either incorporate or address Dr. Martin’s one-to-two-
step limitation, she has not shown that this error prejudiced her substantial rights by
affecting the outcome of the proceeding, or undermining the perceived fairness,
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integrity, or public reputation of the proceedings. On this score, Danner’s argument
runs 	afoul 	of an 	insurmountable obstacle: 	the undisputed 	Vocational 	Expert
testimony indicates that even an incorporation of the most conservative limitations
opined by these experts, including the one-to-two-step limitation, would not have
eroded her ability to perform jobs that exist in significant numbers in the national
economy. Therefore, any errors stemming from the incomplete articulation of the
rationale for crediting only parts of both opinions is harmless where the ambiguity
in the analysis of these opinions would not have affected the final conclusion that
Danner could perform tasks that existed in the national economy.
Recognizing that the burden of showing that an error is harmful normally falls
upon 	the 	party 	attacking 	the 	agency's 	determination, 	and 	confronted 	with
uncontested expert testimony which undermines any claim that any additional
limitations opined by these experts would have changed the ultimate outcome in this
case, we find the ALJ’s error in failing to address these opinions in a more fulsome
way was harmless on the unique facts of this case. Therefore, we are constrained to
affirm that decision.
In closing, this case stands as an example of how the thorough and proper
examination of a vocational expert at a hearing can compensate for the deficient
analysis of medical opinion evidence in the ALJ’s final decision, even when such
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decisions mire us in the thorny briar of one-to-two-step limitations. Moreover,
notwithstanding the argument that this evidence might have been viewed in a way
which would have also supported a different finding, we are obliged to affirm this
ruling once we find that it is “supported by substantial evidence, ‘even [where] this
court acting de novo might have reached a different conclusion.’” Monsour Med.
Ctr. v. Heckler, 806 F.2d 1185, 1190–91 (3d Cir. 1986) (quoting Hunter Douglas,
Inc. v. NLRB, 804 F.2d 808, 812 (3d Cir. 1986)). Since the ALJ’s symptom
assessment in this case complied with the dictates of the law and was supported by
substantial evidence, and any error in the medical opinion analysis was harmless,
under the deferential standard of review that applies to appeals of Social Security
disability determinations, we find that substantial evidence supported the ALJ’s
evaluation of this case and will affirm that decision.
IV. 	Conclusion
Accordingly, 	for 	the 	foregoing 	reasons, 	the 	final 	decision 	of 	the
Commissioner denying this claim will be AFFIRMED.
An appropriate order follows.
s/ Martin C. Carlson
Martin C. Carlson
United States Magistrate Judge
DATED: March 9, 2026
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