Warson v. Commissioner, Social Security Administration

OCR transcription for search; preserved printed pages are authoritative

Case No. 1:23-cv-03402-CNS Document18 _ filed 03/27/25 USDC Colorado pgi
of 17

IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF COLORADO
Judge Charlotte N. Sweeney
Civil Action No. 1:23-cv-03402-CNS
E.W.,
Plaintiff,
V.

COMMISSIONER, Social Security Administration,

Defendant.

ORDER

Plaintiff E.W.' brings this appeal of a denial of disability insurance benefits (DIB)
and supplemental security income (SSI) for a variety of physical and mental impairments.
ECF No. 12 (Opening Br.); Administrative Record (A.R.) at 2412. The ALJ denied the
claims, and Claimant went through the appeals process. For the reasons explained below,
the Court affirms in part and reverses in part the denial of benefits, and remands for further
analysis.

|. BACKGROUND

Plaintiff first filed for DIB and SSI under Title II of the Social Security Act on August

7, 2014, and October 7, 2014, respectively. A.R. at 481, 485. On April 6, 2017, an ALJ

issued an unfavorable decision. A.R. at 48-64. That decision was reversed and remanded

1 Pursuant to D.C.COLO.L.APR 5.2(b), Plaintiff E.W. is identified by her initials only.

AUTHENTICATED
U.S. GOVERNMENT
INFORMATION

GPO

2
for further proceedings on August 21, 2019. A.R. at 2485–95. While the appeal was
pending, Plaintiff filed subsequent DIB and SSI applications in 2019, which were
consolidated, upon remand, with the 2014 applications. A.R. at 2500, 2687, 2700. The
ALJ issued an unfavorable decision on November 13, 2020, which is the relevant decision
for purposes of this appeal. A.R. at 2412–47. Plaintiff appealed, and the Appeals Council
affirmed on October 19, 2023. A.R. at 2408. Plaintiff properly appealed the 2020 decision
to this Court on December 22, 2023. ECF No. 1.
E.W.’s alleged disability onset date is February 13, 2014. A.R. at 485. She alleged
the following disabilities: debilitating migraines; confusion, irritability, sensitivity to light
and sound; fibromyalgia; IBS; PTSD; restless leg syndrome; herniated lumbar discs –
moderate to severe back pain; cervical stenosis – neck pain, shoulder pain, weakness;
cubital tunnel syndrome; and degenerative joint disease. A.R. at 485.
The ALJ 	conducted 	the 	five-step 	sequential 	analysis 	to 	determine 	whether
Petitioner was disabled for purposes of the Act. At step one, the ALJ found that Petitioner
had not engaged in substantial gainful activity since January 13, 2014. A.R. at 2418. At
step two, the ALJ determined that Plaintiff had the severe impairments of lumbar and
cervical degenerative disc disease, osteoarthritis in multiple joints, fibromyalgia, migraine,
anxiety disorder, depressive disorder, and somatic disorder. A.R. at 2418. At step three,
the ALJ found that the impairments did not meet or medically equal one of the listed
impairments. A.R. at 2421. At step four, the ALJ found that Plaintiff could not perform
relevant past work. A.R. at 2433. The ALJ then found that E.W. had the residual functional
capacity (RFC) that:
Case No. 1:23-cv-03402-CNS Document 18 filed 03/27/25 USDC Colorado pg 2
of 17

3
she can occasionally lift and/or carry about 20 pounds, and
can frequently lift and/or carry about 10 pounds. She can
stand and/or walk for about 6 hours in an 8-hour workday. She
can sit for about 6 hours in an 8-hour workday. She can
frequently push and pull with the bilateral upper extremities.
She can never climb tall ladders, ropes, or scaffolds. She can
occasionally climb stairs and ramps. She can occasionally
balance, 	stoop, 	kneel, 	crouch, 	and 	crawl. 	She 	can
occasionally 	reach 	overhead 	with 	the 	bilateral 	upper
extremities. She can frequently handle and finger with the
bilateral upper extremities, and has no other manipulative
limitations. She can occasionally work in extreme heat or cold,
and can occasionally work at unprotected heights, and in
close proximity to dangerous moving machinery. She can
understand 	and 	remember 	tasks 	that 	are 	moderately
complex, meaning work that requires some skills but not more
complex duties that can be learned on the job in about 6
months for average performance. These tasks would involve
independent judgment, multiple steps, and abstract ideas.
She is able to sustain concentration, persistence, and pace
for these instructions over a typical workday and workweek.
She is able to interact appropriately with supervisors and can
tolerate occasional interaction with coworkers. However, work
duties should not require work with the public; although [she]
is able to tolerate superficial public contact. [Plaintiff] is able
to tolerate work changes, make work decisions, and is able to
travel as well as recognize and avoid work hazards.
A.R. at 2424. At step five, the ALJ concluded that there are jobs that exist in significant
numbers in the national economy that the claimant can perform. Thus, the ALJ found that
Plaintiff had not been under a disability, as defined in the Act, from January 13, 2014,
through the date of the decision. A.R. at 2435.
Plaintiff argues that the ALJ’s decision is not supported by substantial evidence.
Plaintiff challenges the ALJ’s decision on three bases, arguing that the ALJ improperly
considered some impairments to be non-severe at step 2, failed to properly determine
Plaintiff’s RFC, and improperly conducted the step 5 analysis.
Case No. 1:23-cv-03402-CNS Document 18 filed 03/27/25 USDC Colorado pg 3
of 17

4
II. LEGAL STANDARD AND STANDARD OF REVIEW
An individual is considered disabled under the Social Security Act if they are unable
to do “any substantial gainful activity” due to any medically determinable physical and/or
mental impairment that can be expected “to last for a continuous period of not less than
12 months.” Wall v. Astrue, 561 F.3d 1048, 1051 (10th Cir. 2009) (quoting 20 C.F.R. §
416.905(a)). An individual bears the initial burden of establishing their disability. See id.
at 1062. To determine whether an individual is disabled, ALJs use a five-step, sequential
analysis that considers whether the individual:
(1) is currently engaged in “substantial gainful activity”;
(2) has a “severe” impairment or impairments;
(3) the impairment or impairments equals one of the impairments listed in the
appendix of the relevant disability regulation;
(4) the impairment or impairments prevent the individual from doing their past
work; and
(5) has the residual functional capacity (RFC) to perform other work in the
national economy.
Allen 	v. 	Barnhart, 	357 	F.3d 	1140, 	1142 	(10th 	Cir. 	2004) 	(citing 	20 	C.F.R. 	§
404.1520(a)(4)). The burden to prove elements one through four falls on the plaintiff.
Fischer-Ross v. Barnhart, 431 F.3d 729, 731 (10th Cir. 2005). However, if Plaintiff “is not
considered disabled at step three, but has satisfied their burden at steps one, two, and
four, the burden shifts to the Commissioner” to show that Plaintiff has the RFC to perform
other work in the national economy, taking into consideration their age, education, and
work experience. Id. Prior to step four, the ALJ must formulate an RFC finding,
Case No. 1:23-cv-03402-CNS Document 18 filed 03/27/25 USDC Colorado pg 4
of 17

5
considering 	the 	limiting 	effects 	of 	all 	of 	the 	claimant’s 	impairments. 	20 	C.F.R. 	§
404.1520(e); Henrie v. United States Department of Health and Human Servs., 13 F.3d
359, 361 (10th Cir. 1993).
Exercising 	jurisdiction 	under 	42 	U.S.C. 	§ 	405(g), 	the 	Court 	reviews 	the
Commissioner’s decision to determine whether the factual findings are supported by
substantial evidence and whether the correct legal standards were applied. See Pisciotta
v. Astrue, 500 F.3d 1074, 1075 (10th Cir. 2007). The Court must evaluate the agency’s
decision “solely by the grounds invoked by the agency,” and may not “affirm the
administrative action by substituting what it considers to be a more adequate or proper
basis.” Hackett v. Barnhart, 475 F.3d 1166, 1174 (10th Cir. 2007).
“Substantial evidence” is evidence that is sufficient, based on the entire record, to
support the ALJ’s factual determinations. See Biestek v. Berryhill, 587 U.S. 97, 102–03
(2022). A district court must “meticulously examine the record as a whole, including
anything that may undercut or detract from the ALJ’s findings in order to determine if the
substantiality test has been met,” but will “not reweigh the evidence or retry the case.”
Flaherty 	v. Astrue, 	515 	F.3d 	1067, 	1070 	(10th 	Cir. 	2007). The 	threshold 	for 	this
“evidentiary sufficiency is not high”; the evidence required is “more than a mere scintilla
and is such relevant evidence as a reasonable mind might accept as adequate to support
a conclusion.” Biestek, 587 U.S. at 103. Nonetheless, a decision is not based on
substantial evidence if it is “overwhelmed by other evidence in the record.” Wall, 561 F.3d
at 1052 (internal quotations omitted). A decision not supported by substantial evidence
must be reversed. Williams v. Bowen, 844 F.2d 748, 750 (10th Cir. 1988).
Case No. 1:23-cv-03402-CNS Document 18 filed 03/27/25 USDC Colorado pg 5
of 17

6
III. ANALYSIS
Plaintiff argues that numerous findings the ALJ made were not supported by
substantial evidence. The Court will address each in turn.
A. Severe Impairments
Plaintiff argues that the ALJ improperly conducted the step two analysis of
assessing whether her impairments are severe. Plaintiff challenges the ALJ’s finding that
two of Plaintiff’s claimed impairments, ankylosing spondylitis (AS) and multiple sclerosis
(MS), were not medically determinable, and so were not severe. A.R. at 2418–21. Plaintiff
also challenges the determination that her knee impairments were not severe. The Court
finds that the ALJ’s findings are supported by substantial evidence.
A 	claimant’s 	“impairment(s) 	must 	result 	from 	anatomical, 	physiological, 	or
psychological abnormalities that can be shown by medically acceptable clinical and
laboratory diagnostic techniques.” 20 C.F.R. 404.1521. Here, the ALJ made a reasonable
conclusion based on the relevant evidence regarding AS. There was no radiographic
evidence that Plaintiff had AS. A.R. at 3294, 2421. One rheumatologist, Dr. Zyskowski,
“suspect[ed]” that Plaintiff had AS, but two other rheumatologists saw no signs of it. A.R.
at 2421, 2307, 2316, 3290. Another doctor, Dr. Timms, noted that Plaintiff had a genetic
marker for a gene mutation that can indicate AS, but concluded that the gene had
uncertain clinical significance. A.R. at 2430. The two doctors’ opinions and the negative
radiography constitutes substantial evidence supporting the conclusion that Plaintiff did
not have medically determinable AS.
Case No. 1:23-cv-03402-CNS Document 18 filed 03/27/25 USDC Colorado pg 6
of 17

7
Similarly, the ALJ reasonably concluded that Plaintiff did not have medically
determinable MS. Plaintiff’s most recent brain MRI and treatment notes did not indicate
the existence of MS. A.R. at 2421, 781, 3917. While earlier reports suggested that MS
was suspected, the diagnostics at that time were not conclusive, and the irregular
diagnostics could indicate migraines as much as MS. A.R. at 2421. Thus, because the
medical diagnostic evidence did not show signs of MS, substantial evidence supports the
conclusion that Plaintiff did not have medically determinable MS. Additionally, as the
Commissioner notes, the ALJ still considered Plaintiff’s symptoms that she attributed to
AS and MS, regardless of the diagnosis. A.R. at 2425–28.
Plaintiff also disputes the ALJ’s conclusion at step two that Plaintiff’s knee
conditions were not severe. The ALJ found that Plaintiff had medically determinable knee
impairments, 	including 	pseudo-gout. 	However, 	the 	ALJ 	determined 	that 	these
impairments were non-severe. The pseudo-gout, for instance, was controlled with
medication. A.R. at 2419, 5637, 5642. Additionally, multiple providers recorded that
Plaintiff had full lower extremity strength, full knee range of motion, and normal gait. A.R.
at 2419, 3321, 5591, 5641. The Court agrees that these findings and treatment constitute
substantial evidence to support the conclusion that the knee conditions were not severe.
While Plaintiff cites contrary evidence in the record, the Court cannot reweigh the
evidence; instead, the inquiry is whether a reasonable factfinder could come to the same
conclusion based on the evidence. Here, a reasonable factfinder could conclude that the
medication and normal capabilities indicate that the condition is not severe. Thus, the
Court finds no reversible error with the ALJ’s determination at step two.
Case No. 1:23-cv-03402-CNS Document 18 filed 03/27/25 USDC Colorado pg 7
of 17

8
B. The Residual Functional Capacity (RFC) Assessment
Plaintiff also argues that the ALJ’s RFC was not supported by substantial evidence,
challenging multiple determinations within the RFC. Plaintiff bears the burden of showing
that limitations should be included in her RFC assessment. Howard v. Barnhart, 379 F.3d
945, 948–49 (10th Cir. 2004). The ALJ found that Plaintiff had the RFC to perform light
work, with limitations as described above. A.R. at 2424. The Court addresses each of
Plaintiff’s challenges to the RFC below.
1. 	Migraine and Headache Analysis
Plaintiff first argues that the ALJ did not sufficiently consider Plaintiff’s headaches
and migraines in formulating the RFC. The Court agrees; the ALJ’s conclusion that the
migraines and headaches did not impact the RFC was not supported by substantial
evidence.
The Commissioner argues that the ALJ relied upon the opinion of Dr. Terry, who
considered 	Plaintiff’s 	medical 	records, 	including 	evidence 	of 	her 	migraines, 	and
concluded that Plaintiff remained capable of a restricted range of light work. However, the
ALJ’s analysis of Dr. Terry’s opinion did not mention anything about migraines and
headaches. The ALJ placed great weight on Dr. Terry’s opined limitations because they
were supported by the physical examination findings and other physical impairments. A.R.
at 2431. The ALJ did not explain how this opinion related to Plaintiff’s migraines. Thus,
the inference that Dr. Terry’s recommended limitations meant that Plaintiff’s migraines did
not affect her functioning is not supported by substantial evidence.
Case No. 1:23-cv-03402-CNS Document 18 filed 03/27/25 USDC Colorado pg 8
of 17

9
The ALJ also found that Plaintiff’s migraines had improved with treatment. A.R. at
2427. However, this conclusion is not supported by substantial evidence. The ALJ
concluded that pain management had helped her migraines because “there is some
indication that the claimant’s other conditions impacted her headache and migraine
symptoms.” A.R. at 2427. The only support for this statement is that Plaintiff’s neurologist
suggested that her headaches improve when her inflammatory episodes resolve and that
Plaintiff had fewer visits with her neurologist after she started pain management. A.R. at
2427. That is not enough support for the conclusion that her migraines and headaches
had improved, despite Plaintiff’s subjective complaints of them and numerous references
in the record to her severe headaches and migraines after 2017. See ECF No. 12 at 49,
n. 9 (collecting migraine and headache references in the record). Additionally, the ALJ
also noted that, with regard to “headaches and migraines, the record reflects the claimant
tried and failed multiple medications.” A.R. at 2426. The ALJ did not adequately explain
the 	conclusion 	that 	Plaintiff’s 	migraines 	had 	improved 	with 	treatment, 	especially
considering the finding that multiple medications had failed.
Plaintiff also argues that the ALJ did not consider that Plaintiff’s migraines require
her to lie down or be absent from work when formulating the RFC. The Court agrees. The
ALJ did not seem to consider the treating neurological assistant’s opinion that Plaintiff’s
work capacity was subject to breaks and unexcused absences in formulating the RFC.
A.R. at 853–58. Nor did the ALJ explain how the migraines and headaches were or were
not included in the RFC. In sum, the ALJ did not adequately assess Plaintiff’s migraines
in determining her RFC. The Court remands the case for further analysis on how Plaintiff’s
Case No. 1:23-cv-03402-CNS Document 18 filed 03/27/25 USDC Colorado pg 9
of 17

10
headaches and migraines affect her RFC, and, by extension, how that RFC would affect
the work she is able to perform at step 5.
2. 	Combined Impact of Plaintiff’s Impairments
Plaintiff next argues that the ALJ did not consider the combined impacts of
Plaintiff’s impairments in formulating the RFC, considering that Plaintiff reported having
debilitating symptoms. The ALJ found that the severity of Plaintiff’s reported symptoms
was inconsistent with other evidence in the record, notably her daily activities, objective
medical records, and improvement after treatment. However, because the Court finds that
the ALJ did not sufficiently address Plaintiff’s headaches and migraines, the analysis of
Plaintiff’s combined symptoms is necessarily also deficient. While the medical records
and improvement indicate that some of Plaintiff’s symptoms are less debilitating than
reported, particularly her physical symptoms, the Court finds that the ALJ’s analysis of
her combined symptoms did not sufficiently address her migraines and headaches,
particularly in concluding that her daily activities undermined their severity.
The 	RFC 	assessment 	must 	address 	the 	claimant’s 	reported 	symptoms, 	in
conjunction with other evidence. See 20 C.F.R. § 404.1529. Plaintiff reported that she had
debilitating symptoms: constant headaches, back pain, and neck pain, general pain,
osteoarthritis, fibromyalgia and migraines leaving her unable to concentrate, and an
inability to walk more than half a block, stand more than 30 minutes, sit longer than one
to two hours, lift more than ten pounds, or pay attention for more than five minutes. A.R.
at 564, 2789, 2795.
Case No. 1:23-cv-03402-CNS Document 18 filed 03/27/25 USDC Colorado pg 10
of 17

11
The ALJ found that Plaintiff’s reported symptoms were inconsistent with objective
medical evidence in the record. For instance, the ALJ pointed to multiple records, most
recently from 2020, showing that Plaintiff had normal gait, normal station, and normal
strength. A.R. at 5591, 5634, 5641; Huston v. Bowen, 838 F.2d 1125, 1132 (10th Cir. 1988)
(an ALJ may consider “the consistency or compatibility of nonmedical testimony with
objective medical evidence”). The ALJ found that these records undermined Plaintiff’s
report that she had weakness and difficulty walking. The ALJ also noted that medical
records indicated that Plaintiff often displayed normal judgment, affect, speech, thought
process, memory, intelligence, and insight, although Plaintiff’s mental status findings were
also sometimes abnormal. The ALJ found that this evidence was inconsistent with
Plaintiff’s reported symptoms of confusion and difficulties with memory, concentration,
completing tasks, understanding, following instructions, and getting along well with
others. A.R. at 2425. The ALJ cited normal, or minimally abnormal, mental status
examination findings in support. The Court finds that these medical records constitute
substantial evidence supporting these conclusions.
The ALJ also found that evidence of Plaintiff’s effective treatment undermined her
reported debilitating symptoms. She had neck surgery in October 2014, after which she
reported doing well without any upper extremity numbness or tingling. A.R. at 2426, 904.
She had treatment for recurrent infections and arthralgia symptoms, which also helped
her neck symptoms. A.R. at 2426, 3188, 2304. The ALJ cited to notes in the record that,
as a result of the treatment, Plaintiff had improved function. A.R. at 2427, 5587, 5592,
5612. The Court agrees that these conclusions are supported by substantial evidence.
Case No. 1:23-cv-03402-CNS Document 18 filed 03/27/25 USDC Colorado pg 11
of 17

12
However, the Court finds that the ALJ’s conclusions regarding Plaintiff’s migraines,
particularly 	the 	inferences 	made 	about 	her 	daily 	activities, 	are 	not 	supported 	by
substantial evidence. The ALJ found that Plaintiff performed daily activities and part-time
work that undercut the severity of her reported symptoms: she cared for her son in 2014;
she worked eight months as an in-home babysitter for four children in 2015; she worked
as a live-in nanny in 2017; she started a babysitting job in 2019; and she worked as a taxi
driver from 2019 to 2020, which required her to lift luggage and occasionally drive hours
from Colorado Springs to the Denver airport. A.R. at 2425–26. While part-time work does
not constitute substantial gainful activity, it may be considered in evaluating how much
work a claimant can do. See Markham v. Califano, 601 F.2d 533, 534 (10th Cir. 1979).
This is particularly true where, as here, the part-time work is used to evaluate a claimant’s
reported symptoms, rather than evidence that the claimant can do full-time work. See
Wilson v. Astrue, 602 F.3d 1136, 1145-46 (10th Cir. 2010). Plaintiff argues that these
activities do not undermine the severity of Plaintiff’s migraine symptoms because they
were flexible jobs that allowed her to take long breaks, choose her hours, and not work
on bad days. ECF No. 12 at 66. Plaintiff also notes that she was often accompanied or
assisted in her daily activities and childcare jobs. Id. The Court agrees that these activities
do not necessarily conflict with the severity of Plaintiff’s reported migraine and headache
symptoms, and finds that the ALJ did not adequately explain how these activities were
inconsistent with her reported migraines in combination with her other symptoms.
Because the Court is remanding the case for a more substantial analysis of the
impact of Plaintiff’s headaches and migraines on her RFC, it follows that the ALJ should
Case No. 1:23-cv-03402-CNS Document 18 filed 03/27/25 USDC Colorado pg 12
of 17

13
conduct a new analysis on the combined impacts of Plaintiff’s symptoms, including her
migraines and headaches. In conducting this analysis, the ALJ should consider the nature
of Plaintiff’s previous part-time work and daily activities, particularly whether she had
assistance and how often she was unable to work, in assessing whether these activities
were inconsistent with the reported combined impact of her symptoms.
C. Medical Opinions
Plaintiff also argues that the ALJ did not properly consider the various medical
opinions. The ALJ noted that many of the opinions conflicted and ultimately found that
Plaintiff’s limitations were in the middle of those recommended by the medical providers,
without fully adopting any. This approach is appropriate, as long as it is supported by
substantial evidence. See Smith v. Colvin, 821 F.3d 1264, 1268 (10th Cir. 2016)
(upholding ALJ’s assessment that was “between the two medical opinions without fully
embracing either one”). The Court will consider whether the ALJ properly rejected certain
medical opinions.
1. 	Dr. Sokalski
Social Security regulations require ALJs to evaluate medical opinion evidence
based on (1) supportability; (2) consistency; (3) relationship with the claimant; (4)
specialization; and (5) other factors, such as familiarity with the other evidence in the
claim. 20 C.F.R. §§ 404.1520c(c), 404.1520(c); see also C.M.D. v. Comm’r of Soc. Sec.,
No. 	1:22-CV-01005-DDD, 	2022 	WL 	18141574, 	at 	*1 	(D. 	Colo. 	Dec. 	9, 	2022).
Supportability and consistency are the most important factors, and ALJs must explain how
they considered those factors in the decision. See 20 C.F.R § 404.1520c(b). An ALJ
Case No. 1:23-cv-03402-CNS Document 18 filed 03/27/25 USDC Colorado pg 13
of 17

14
cannot reject an examining or treating doctor’s opinion as unsupported or inconsistent
without providing an explanation supported by substantial evidence. Woods v. Kijakazi,
32 F.4th 785, 792 (9th Cir. 2022) (internal citations omitted).
First, the ALJ found Dr. Sokalski’s recommended limitations to be inconsistent with
other evidence in the record. Dr. Sokalski opined that Plaintiff had a limited ability to
handle and finger and had postural and lifting limitations. A.R. at 24, 2430. The ALJ found
that the handling and fingering limitations were supported by his treatment notes, which
noted osteoarthritic changes in her hands, but that the postural and lifting limitations were
inconsistent with other evidence in the record. A.R. at 2430. Evidence of Plaintiff’s
activities in the record, for instance, undermined these limitations: she had good function
in her daily living activities in 2014, worked as an in-home babysitter of four children in
2015, worked as a live-in nanny in 2017, and worked as a taxi driver in 2019 and 2020,
which involved lifting luggage. The Court finds that a reasonable fact finder could
conclude that these activities are inconsistent with a recommended limitation precluding
all postural activities.
The ALJ also noted that Dr. Sokalski’s limitations were inconsistent with treatment
records from other providers. A.R. at 2431. The treatment records generally recorded
normal gait, station, range of motion, strength, and sensation. A.R. at 2431, 5586–5660.
The Court agrees that substantial evidence supports the ALJ’s finding that Dr. Sokalski’s
opinion was inconsistent with the record.
Case No. 1:23-cv-03402-CNS Document 18 filed 03/27/25 USDC Colorado pg 14
of 17

15
2. 	Dr. Timms
The ALJ found Dr. Timms’s opinion unpersuasive because it was unsupported by
his own treatment notes and was inconsistent with the record, namely objective medical
evidence and Plaintiff’s activities. Dr. Timms limited Plaintiff to lifting no more than 10
pounds, standing and walking for less than two hours, sitting less than six hours, and
postural and manipulative limitations. A.R. at 2430, 4983. However, Dr. Timms arrived at
these assessments because Plaintiff had a genetic marker for a gene mutation that can
indicate AS. A.R. at 2430. As discussed above, the ALJ reasonably concluded that this
marker was insufficient evidence that Plaintiff had medically determinable AS, so the ALJ
reasonably concluded that limitations based on suspected AS were not sufficiently
supported.
Additionally, the ALJ concluded that this finding was not supported by Dr. Timms’s
notes. He noted that Plaintiff had other normal findings that argued against AS, and that
the gene marker had uncertain clinical significance. A.R. at 2430, 4983. Dr. Timms also
opined that Plaintiff had neuropathy, while also noting normal sensory, motor, and
cerebellar functions. A.R. at 2430, 4983. The Court agrees that the ALJ reasonably
concluded that these findings conflict with Dr. Timms’s recommendations, and so his
conclusions are not supported.
Finally, the ALJ found that Dr. Timms’s opined limitations were inconsistent with
other evidence in the record. Notably, an October 2017 electromyography (EMG) found
no evidence of neuropathy. Additionally, as discussed above, the evidence of her daily
activities undermines his finding of significant postural limitations. A.R. at 2430, 4983. The
Case No. 1:23-cv-03402-CNS Document 18 filed 03/27/25 USDC Colorado pg 15
of 17

16
Court finds that the ALJ’s conclusions that Dr. Timms’s opinions were unsupported and
inconsistent are supported by substantial evidence.
D. Step Five Analysis
Finally, Plaintiff challenges the ALJ’s determination at step five of the analysis that
other work exists in significant numbers in the national economy that Plaintiff can perform.
The Court finds that the ALJ appropriately relied on a vocational expert who based their
opinion on a hypothetical individual with Plaintiff’s age, education, work experience, and
RFC. A.R. at 2899. The vocational expert opined that such an individual could perform
work in six representative occupations, three light and three sedentary. A.R. at 2900. This
expert’s opinion constitutes substantial evidence that the ALJ relied upon in the step five
finding. See Gay v. Sullivan, 986 F.2d 1336, 1341 (10th Cir. 1993) (when the findings
regarding a claimant’s impairment are adequately reflected in the ALJ’s hypothetical
questions 	to 	the 	vocational 	expert, 	the 	vocational 	expert’s 	testimony 	constitutes
substantial evidence to support the ALJ’s related determination). However, Plaintiff also
argues that the hypotheticals given to the vocational expert did not match Plaintiff’s RFC.
ECF No. 17 at 14. The Court need not address this argument. In light of the Court’s finding
that the ALJ’s RFC determinations did not adequately consider Plaintiff’s migraines and
headaches, the Court concludes that a new analysis at step 5 may also be necessary
after determining an RFC that properly considers Plaintiff’s migraines and headaches.
The hypotheticals given to the vocational expert must match the updated RFC.
Case No. 1:23-cv-03402-CNS Document 18 filed 03/27/25 USDC Colorado pg 16
of 17

Case No. 1:23-cv-03402-CNS Document 18 _ filed 03/27/25 USDC Colorado pgi17
of 17

IV. CONCLUSION
For the reasons set forth above, the Court AFFIRMS in part and REVERSES in
part the Commissioner’s decision denying Plaintiffs DIB and SSI benefits, and

REMANDS for further proceedings consistent with this order.”

Dated this 27th day of March 2025.

2 The Court does not address Plaintiff's request for immediate award of benefits due to the Court's limited
remand.

17