Savage v. Commissioner of Social Security

IN THE UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF OHIO
EASTERN DIVISION
JOSEPH L. SAVAGE,
Plaintiff,
vs.
COMMISSIONER OF SOCIAL
SECURITY,
Defendant.
CASE NO. 5:25-cv-762
MAGISTRATE JUDGE
JAMES E. GRIMES JR.
MEMORANDUM OPINION
AND ORDER
Plaintiff Joseph L. Savage filed a complaint against the Commissioner
of Social Security seeking judicial review of the Commissioner’s decision
denying his applications for supplemental security income and disability
insurance benefits. Doc. 1. This Court has jurisdiction under 42 U.S.C. §§
405(g) and 1383(c). The parties consented to my jurisdiction in this case. Doc.
4. 	Following 	review, 	and 	for 	the 	reasons 	stated 	below, 	I 	affirm 	the
Commissioner’s decision.
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Procedural Background
In November 2022, Savage filed applications for both supplemental
security income and disability insurance benefits, alleging a disability onset
date of August 14, 2022.1 Tr. 157–66. In pertinent part, Savage alleged that he
was disabled and unable to work due to the following impairments: warm
blooded hemolytic anemia, peripheral arterial disease, Type-2 diabetes, and
hypertension. Tr. 194.
In June 2023, Savage requested a hearing. Tr. 104. Administrative Law
Judge (“ALJ”) Mary Lohr held a telephone hearing in February 2024. Tr. 31.
Savage appeared, testified, and was represented by counsel at the February
2024 hearing. Tr. 34. Qualified vocational expert Lynn Smith also testified. Id.
In April 2024, the ALJ issued a written decision, which found that Savage was
not entitled to benefits. Tr. 14–30.
In April 2024, Savage appealed the ALJ’s decision to the Appeals
Counsel. Tr. 155. In February 2025, the Appeals Counsel denied Savage’s
appeal, 	making 	the 	ALJ’s 	April 2024 decision 	the 	final decision 	of 	the
Commissioner. Tr. 1; see 20 C.F.R. § 404.981.
Savage timely filed this action in April 2025. Doc. 1. In his opening brief,
Savage raises four issues:
1 	“Once a finding of disability is made, the [agency] must determine the
onset date of the disability.” McClanahan v. Comm’r of Soc. Sec., 193 F. App’x
422, 425 (6th Cir. 2006).
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1. 	The ALJ erred at Step Three of the Sequential
Evaluation 	when 	she 	failed 	to 	find 	that
Plaintiff satisfied the criteria of Listing 4.12.
2. 	The ALJ erred when she failed to support her
conclusions 	or 	discuss 	supportability 	and
consistency when she evaluated the opinions
of the treating sources.
3. 	The ALJ erroneously failed to comply with
Social Security Ruling 16-3p when evaluating
the totality of Plaintiff’s symptoms.
4. 	The 	ALJ’s 	finding 	that 	Plaintiff 	did 	not
require the use of a cane for both ambulation
and 	standing 	was 	not 	supported 	by
substantial evidence.
Doc. 8, at 1.
Evidence
The parties do not dispute the ALJ’s description of the medical record,
so the ALJ’s summary of the evidence is incorporated as follows:
The claimant’s primary health concern is peripheral
arterial 	disease 	in 	his 	legs. 	The 	claimant 	was
hospitalized from August 10 through August 17,
2021, after presenting with pain and discoloration in
the right great toe (1F1). Diagnostic studies on
intake showed near complete occlusion of the right
external iliac artery, and severe stenosis of the right
SFA and popliteal artery with minimal tibial runoff
(1F3). Due to the shown severity of occlusion in the
right lower extremity, the claimant had stenting
placed therein on August 16, 2021 (1F4). Upon
discharge, the claimant was started on a medicinal
regime of Plavix and warfarin (2F19).
Generally, the record does not reflect an episode of
peripheral arterial disease symptoms as severe as
those that led to this hospitalization in August 2021.
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Diagnostic studies dated December 19, 2022 showed
mild arterial occlusive disease in the right lower
extremity, and moderate occlusive disease in the left
(9F67). A few months later on February 16, 2023,
diagnostic 	studies 	demonstrated 	severe
atherosclerotic 	disease 	in 	the 	left 	external 	iliac
artery, and seventy five percent stenosis in the distal
left external iliac artery (9F48-9). These findings led
to stenting placed in the left lower extremity (9F48-
9).
Since 	this 	stent 	placement 	in 	the 	left 	lower
extremity, 	diagnostic 	imaging 	of 	the 	lower
extremities 	have 	consistently 	been 	negative 	for
findings of occlusive arterial disease. Imaging dated
February 20, 2023, June 1, 2023, and December 5,
2023 all showed no evidence of occlusive arterial
disease in the bilateral lower extremities (6F5, 9F6,
9F32). 	These 	studies 	indicate 	that 	the 	stent
placements 	in 	both 	lower 	extremities 	were 	and
remain 	effective 	at 	preventing 	further 	acute
exacerbations of leg pain, swelling, discoloration,
and or sensation loss.
The claimant’s testimony of needing to elevate his
legs each day is not consistent with the diagnostic
findings 	showing 	no 	lower 	extremity 	occlusive
disease since February 16, 2023. That claim as it
pertains to the right lower extremity in particular is
inconsistent 	with 	the 	record 	dating 	back 	to
discharge from the hospital on August 17, 2021
because the record shows no recurrent, significant
occlusive disease in the right lower extremity since
stent placement on August 16, 2021 (9F6, 32, 67,
6F5). Clinical examinations subsequent to the stent
placement in the respective legs have generally not
shown any recurrent, significant edema in either
lower extremity (e.g., 9F444).
The claimant’s ability to engage in weight bearing
activity 	is 	further 	complicated 	by 	other 	severe
impairments 	however. 	Laboratory 	results 	have
consistently demonstrated findings of anemia (e.g.,
6F7). Red and white blood cell counts, along with
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hemoglobin, and hematocrit have all been low on a
consistent basis since the alleged onset date (e.g.,
9F4, 8). However, these measures have not been
markedly abnormal, often falling just below normal
levels 	(9F4, 	8). 	Thus, 	I 	find 	the 	claimant’s
allegations of anemia related pain and fatigue to be
only partially consistent with the record. I note as
well that the treatment the claimant has received for
this condition has been conservative in nature.
An MRI of the lumbar spine dated September 29,
2023 showed grade 1 anterolisthesis of L4 on L5
with mild to moderate degenerative changes at L3-
4, L4-5, and L5-S1 (9F24). The record does not
reflect much follow up concerning treatment for
lower back pain however. However, any lower back
pain is likely made worse by the presence of obesity,
evidenced by a body mass index [BMI] of between
thirty and thirty five (e.g., 2F19). While the record
does not contain specific signs of complication due to
obesity, that impairment plus lower back pain do
reasonably relate to his allegations of fatigue and
muscle weakness after exertion.
The 	record 	also 	reflects 	diagnoses 	for 	other
impairments, 	including 	hypertension,
hyperlipidemia, 	and 	diabetes 	mellitus. 	I 	have
considered 	hypertension 	and 	hyperlipidemia 	as
severe in the context of a record that shows arterial
occlusion at various points, in the lower extremities.
These 	impairments 	are 	further 	cardiovascular
concerns, and likely have played some role in the
development of said arterial disease. That said, the
record 	contains 	little 	to 	no 	objective 	evidence
detailing how hypertension and or hyperlipidemia
significantly affect the claimant’s ability to work. I
have generally considered them as severe as they
related to poor cardiovascular functioning. In terms
of 	diabetes, 	treatment 	records 	do 	show 	the
claimant’s blood glucose levels remain high, despite
his 	taking 	metformin 	(6F5, 2F19). 	Much 	of 	the
reports of sensation loss and weakness in the lower
extremities 	due 	to 	diabetes 	overlaps 	with 	the
complaints of arterial disease symptoms. I have
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considered such symptoms, but note the record does
not show the claimant to exhibit signs of acute
strength loss in the lower extremities despite all of
his severe impairments.
Tr. 21–22.
The ALJ’s Decision
The ALJ made the following findings of fact and conclusions of law:
1. 	The 	claimant 	meets 	the 	insured 	status
requirements 	of 	the 	Social 	Security 	Act
through December 31, 2027.
2. 	The claimant has not engaged in a substantial
gainful activity since August 14, 2022, the
alleged onset date (20 CFR 404.1571 et seq.,
and 416.971 et seq.).
3. 	The 	claimant 	has 	the 	following 	severe
impairments: 	diabetes, 	anemia,
hypertension, 	peripheral 	arterial 	disease,
obesity, 	hyperlipidemia, 	degenerative 	disc
disease 	of 	the 	lumbar 	spine 	(20 	CFR
404.1520(c) and 416.950(c)).
4. 	The claimant does not have an impairment or
combination of impairments that meets or
medically equals the severity of one of the
listed 	impairments 	in 	20 	CFR 	Part 	404,
Subpart P, Appendix 1 (20 CFR 404.1520(d),
404.1525, 404.1526, 416.920(d), 416.925 and
416.926).
5. 	After 	careful 	consideration 	of 	the 	entire
record, 	I 	find 	that 	the 	claimant 	has 	the
residual 	functional 	capacity[2] 	to 	perform
2 	An RFC is an “assessment of” a claimant’s ability to work, taking his or
her “limitations … into account.” Howard v. Comm’r of Soc. Sec., 276 F.3d 235,
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sedentary 	work 	as 	defined 	in 	20 	CFR
404.1567(a) and 416.967(a) except with the
following additional limitations. The claimant
can occasionally climb ramps and stairs, but
cannot climb ladders, ropes, or scaffolds. The
claimant 	can 	occasionally 	balance, 	stoop,
kneel, crouch, and crawl. The claimant cannot
work at unprotected heights or near moving,
mechanical parts. The claimant requires a
cane for ambulation.
6. 	The claimant is unable to perform any past
relevant work (20 CFR 1565 and 416.965).
7. 	The claimant was born on March 5, 1977 and
was 	45 	years 	old, 	which 	is 	defined 	as 	a
younger individual age 45–49, on the alleged
disability onset date (20 CFR 404.1563 and
416.963).
8. 	The 	claimant 	has 	at 	least 	a 	high 	school
education (20 CFR 404.1564 and 416.964).
9. 	Transferability of job skills is not material to
the determination of disability because using
the Medical-Vocational Rules as a framework
supports a finding that the claimant is “not
disabled,” whether or not the claimant has
transferable job skills (See SSR 82-41 and 20
CFR Part 404, Subpart P, Appendix 2).
10. 	Considering the claimant’s age, education,
work 	experience, 	and 	residual 	functional
capacity, 	there 	are 	jobs 	that 	exist 	in
significant numbers in the national economy
239 (6th Circ. 2002). Essentially, it is the Social Security Administration’s
“description of what the claimant ‘can and cannot do.’” Webb v. Comm’r of Soc.
Sec., 368 F.3d 629, 631 (6th Cir. 2004) (quoting Howard, 276 F.3d at 239).
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that 	the 	claimant 	can 	perform 	(20 	CFR
404.1569, 404.1569a, 416.969, and 416.969a).
11. 	The claimant has not been under a disability,
as defined in the Social Security Act, from
August 14, 2022, through the date of this
decision (20 CFR 404.1520(g) and 416.920(g)).
Tr. 19–26.
Standard for Disability
Eligibility for social security benefit payments depends on the existence
of a disability. 42 U.S.C. §§ 423(a), 1382(a). “Disability” is defined as the
“inability to engage in any substantial gainful activity by reason of any
medically determinable physical or mental impairment which can be expected
to result in death or which has lasted or can be expected to last for a continuous
period of not less than 12 months[.]” 42 U.S.C. § 423(d)(1)(A); see also 42 U.S.C.
§ 1382c(a)(3)(A).
An ALJ is required to follow a five-step sequential analysis to make a
disability determination:
1. 	Is the claimant engaged in substantial gainful
activity? If so, the claimant is not disabled.
2. 	Does 	the 	claimant 	have 	a 	medically
determinable impairment, or a combination of
impairments, 	that 	is 	“severe”? 	If 	not, 	the
claimant is not disabled.
3. 	Does the claimant’s impairment meet or equal
one of the listed impairments and meet the
duration requirement? If so, the claimant is
disabled. If not, the ALJ proceeds to the next
step.
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4. 	What is the claimant’s residual functional
capacity and can the claimant perform past
relevant 	work? 	If 	so, 	the 	claimant 	is 	not
disabled. If not, the ALJ proceeds to the next
step.
5. 	Can 	the 	claimant 	do 	any 	other 	work
considering the claimant’s residual functional
capacity, 	age, 	education, 	and 	work
experience? If so, the claimant is not disabled.
If not, the claimant is disabled.
20 C.F.R. §§ 404.1520, 416.920; see Jordan v. Comm’r of Soc. Sec., 548 F.3d
417, 422 (6th Cir. 2008). Under this sequential analysis, the claimant has the
burden of proof at steps one through four. Jordan, 548 F.3d at 423. The burden
shifts to the Commissioner at step five “to prove the availability of jobs in the
national economy that the claimant is capable of performing.” Id. “The
claimant, however, retains the burden of proving her lack of residual functional
capacity.” Id. If a claimant satisfies each element of the analysis and meets the
duration requirements, the claimant is determined to be disabled. Walters
Comm’r of Soc. Sec., 127 F.3d 525, 529 (6th Cir. 1997).
Standard of Review
A reviewing court must affirm the Commissioner’s conclusions unless it
determines “that the ALJ has failed to apply the correct legal standards or has
made findings of fact unsupported by substantial evidence in the record.”
Jordan, 548 F.3d at 422. “‘[S]ubstantial evidence’ is a ‘term of art’” under which
“a court … asks whether” the “existing administrative record … contains
‘sufficien[t] evidence’ to support the agency’s factual determinations.” Biestek
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v. Berryhill, 587 U.S. 97, 102 (2019) (citations omitted). The substantial
evidence standard “is not high.” Id. Substantial evidence “is ‘more than a mere
scintilla’” but it “means only[] ‘such relevant evidence as a reasonable mind
might accept as adequate to support a conclusion.’” Id. at 103 (citations
omitted). The Commissioner’s “findings … as to any fact if supported by
substantial evidence [are] conclusive.” 42 U.S.C. § 405(g); Biestek, 587 U.S. at
99.
A court may “not try the case de novo, resolve conflicts in evidence, or
decide questions of credibility.” Bass v. McMahon, 499 F.3d 506, 509 (6th Cir.
2007). Even if substantial evidence or a preponderance of the evidence
supports 	a 	claimant’s 	position, 	a 	reviewing 	court 	cannot 	overturn 	the
Commissioner’s decision “so long as substantial evidence also supports the
conclusion reached by the ALJ.” Jones v. Comm’r of Soc. Sec., 336 F.3d 469,
477 (6th Cir. 2003). This is so because there is a “zone of choice within which”
the Commissioner can act, without fear of judicial “interference.” Lindsley v.
Comm’r of Soc. Sec., 560 F.3d 601, 605 (6th Cir. 2009) (quoting Felisky v.
Bowen, 35 F.3d 1027, 1035 (6th Cir. 1994)).
Discussion
1. 	The ALJ did not err when she found that Savage’s impairments
failed to meet or equal Listing 4.12.
Savage begins by arguing that the ALJ erred at Step Three when she
“failed to note that the record supported the fact that [Savage] satisfied the
criteria of Listing 4.12.” Doc. 8, at 8.
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At Step Three of the disability evaluation process, a claimant will be
found disabled if his impairments meet or equal one of the listings in the
Listing of Impairments. 20 C.F.R. § 404.1520(a)(4)(iii).3 The claimant bears the
burden of establishing that any condition meets or equals a listing. Thacker v.
Soc. Sec. Admin., 93 F. App’x 725, 727–28 (6th Cir. 2004) (citing Buress v. Sec’y
of Health & Human Servs., 835 F.2d 139, 140 (6th Cir. 1987)). A claimant
“must present specific medical findings that satisfy the various tests listed in
the description of the applicable impairment or present medical evidence which
describes how the impairment has such equivalency.” Id. at 728 (citing Evans
v. Sec’y of Health & Human Servs., 820 F.2d 161, 164 (6th Cir. 1987)). “Each
listing specifies the objective medical and other findings needed to satisfy the
criteria of that listing” and a claimant “must satisfy all the criteria to ‘meet’
the listing.” Reynolds v. Comm’r of Soc. Sec., 424 F. App’x 411, 414 (6th Cir.
2011). 	“[A] 	claimant 	is 	also 	disabled 	if 	her 	impairment 	is 	the 	medical
equivalent of a listing[.]” Id. There is no heightened articulation standard at
step three. Bledsoe v. Barnhart, 165 F. App’x 408, 411 (6th Cir. 2006).
Here, Savage argues that the ALJ erred at Step Three when she found
that his impairments did not meet or medically equal Listing 4.12. Doc. 8, at
3 	The “listings” are found at 20 C.F.R Part 404, Subpart P, App. 1. They
are a catalog of disabling impairments organized by “body systems.” Generally,
each body system section has an Introduction, which contains information
relevant to that system, and a Category of Impairments, which contains each
numbered listing. Each listing describes the objective medical and other
findings needed to satisfy the criteria of that listing. Id.; 20 C.F.R. § 404.1525.
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7. 	This 	means 	that 	to 	succeed 	with 	this 	claim 	Savage 	must 	show 	his
impairments met or medically equaled the requirements of Listing 4.12 during
the relevant period of alleged disability. See Thacker, 93 F. App’x at 728. To
meet or equal Listing 4.12, concerning peripheral arterial disease, Savage
must show that he has intermittent claudication and one of the following
conditions: (A) a resting ankle or brachial systolic blood pressure ratio of less
than .50; (B) a decrease in systolic blood pressure at his ankle on exercise of at
least 50 percent of pre-exercise level and that takes at least 10 minutes to
return to pre-exercise level; (C) a resting toe systolic blood pressure of less than
30 mm Hg; or (D) a resting toe or brachial systolic blood pressure ratio of less
than .40. See 20 C.F.R Part 404, Subpart P, Appendix 1, Subsection 4.12.
Savage claims that the “medical evidence established that [he] had
intermittent claudication (Tr. 298, 675, 920, 1000) along with a right lower
extremity brachial index of 0.45 (Tr. 341).” Id. at 7–8. Savage thus concludes
that the ALJ’s conclusion that “the stents placed in both lower extremities
remained effective at preventing acute exacerbations” was incorrect because it
was “contrary to the medical evidence which reported that [he] had lifestyle
limiting claudication of the left leg in February 2023.” Doc. 8, at 8 (citing Tr.
21 	(the 	ALJ’s 	statement) 	and 	Tr. 	1000 	(the 	medical 	record)). 	Savage’s
argument, however, conflates the requirement of intermittent claudication,
which 	he 	experienced, 	with 	the 	brachial 	systolic 	blood 	pressure 	ratio
measurement of record.
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While the record Savage cites states “patient with lifestyle limiting
claudication of left leg,” Tr. 1000, it does not show that he had a lower
extremity brachial systolic blood pressure ratio of less than .50 in his leg during
the alleged disability period. As the Commissioner points out, the sole citation
that Savage provides in relation to his brachial systolic blood pressure ratio is
from August 2021. See Doc. 10, at 5 (citing Savage’s brief, Doc. 8, at 8, which
included the brachial systolic blood pressure ratio provided at Tr. 341).
Savage’s disability onset date, however, was August 2022––approximately one
year later. See Tr. 157. The ratio Savage cites is thus from outside of the
relevant time period for the disability applications at issue.4 Savage offers no
explanation for how this time discrepancy affects the ALJ’s evaluation and he
does not offer a convincing response to the Commissioner’s well-supported
position that the August 2021 ratio is irrelevant to the Listing analysis since
it was created outside of the disability period. See Doc. 10, at 5–6 (identifying
4 	Savage filed applications under Titles II and XVI of the Social Security
Act for disability insurance benefits under Title II and supplemental security
income under Title XVI. Tr. 157–66. Under Title II, an eligible claimant must
establish disability on or before the date last insured. See 20 C.F.R. §§ 404.101,
404.130–31. Savage alleges a disability onset date of August 14, 2022. Tr. 160.
His date last insured is December 31, 2026. Tr. 203. So Savage’s relevant time
period under Title II runs from August 14, 2022, through December 31, 2026.
The time period relevant in a Title XVI claim for supplemental security
income runs from the date on which the claimant filed his or her application.
20 C.F.R. §§ 416.330, 416.335; see Bogle v. Sullivan, 998 F.2d 342, 346 n.2 (6th
Cir. 1993). Savage filed his Title XVI claim on November 25, 2022. Tr. 157–
159. So the relevant time period for Savage’s Title XVI claim runs from
November 25, 2022, until April 3, 2024, the date on which the ALJ issued her
decision. Tr. 14.
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that the only medical record showing a resting ankle/brachial systolic blood
pressure ratio less than .50 was dated August 2021 and asserting that Savage
failed to show he met all requirements of Listing 4.12 during the relevant
period); Doc. 11, at 1 (replying without support that “[t]he issue is not when
the test occurred, but whether Plaintiff had the test results of Listing level
severity”). Indeed, Savage’s briefing seems to ignore the fact that the ALJ’s
finding was not contrary to the medical evidence.
Despite recognizing that he bears the burden to show that he met the
listing requirements and admitting that “the ALJ discussed the evidence,”
Savage concludes that “the medical evidence, as set forth above, provided
substantial evidence that [he] satisfied the criteria of the relevant Listing.”
Doc. 8, at 8–9. In essence, Savage’s argument is that the ALJ’s omission of any
discussion surrounding the August 2021 record shows she “failed to properly
consider the relevant evidence in light of the applicable Listing” and, thus, her
decision couldn’t be supported by substantial evidence. But the ALJ said she
considered the entire record. See e.g., Tr. 20. Absent evidence to the contrary,
the Court will presume that this statement is true. See NLRB v. Newark Elec.
Corp., 14 F.4th 152, 163 (2d Cir. 2021); see also United States v. Chemical
Found., Inc., 272 U.S. 1, 14–15 (1926) (“The presumption of regularity supports
the official acts of public officers, and, in the absence of clear evidence to the
contrary, courts presume that they have properly discharged their official
duties.”); cf. Higgs v. Bowen, 880 F.2d 860, 864 (6th Cir. 1988) (noting that the
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Appeals Council “state[d] that it ‘considered the entire record which was before
the administrative law judge, including the testimony at the hearing’”). It
bears repeating that the August 2021 record is irrelevant to Savage’s instant
disability claim, because it was created approximately one year before Savage’s
disability onset date. So it is unclear why the ALJ would have needed to cite
it. Regardless, the ALJ’s failure to cite a particular record does not mean that
the ALJ failed to consider that record.5 See Thacker v. Comm’r of Soc. Sec., 99
F. App’x 661, 665 (6th Cir. 2004) (“An ALJ need not discuss every piece of
evidence in the record for his decision to stand.”); Byler v. Kijakazi, No. 5:20-
cv-1822, 2022 WL 980099, at *9 (N.D. Ohio Jan. 21, 2022) (“with a nearly one-
thousand page record, the ALJ cannot be expected to discuss every piece of
evidence that Plaintiff believes is inconsistent with the RFC”), report and
recommendation adopted, 2022 WL 971384 (N.D. Ohio Mar. 31, 2022).
Savage’s 	failure 	to 	show 	that 	the 	ALJ 	needed 	to 	explain 	her
consideration of a record created approximately one year before the disability
onset date matters because “so long as substantial evidence supports the
conclusion reached by the ALJ,” it doesn’t matter if substantial evidence also
supports his position. Key v. Callahan, 109 F.3d 270, 273 (6th Cir. 1997). As to
5 	To be sure, the ALJ was aware of the August 2021 finding. The ALJ
noted Savage’s hospitalization in August 2021 and explained that imaging
from February through December 2023 “showed no evidence of occlusive
arterial disease” and that “as it pertains to the right lower extremity in
particular[,] … the record shows no recurrent, significant occlusive disease in
the right lower extremity since stent placement on August 16, 2021[.]” Tr. 21–
22 (citing Exhibits 9F6, 32, 67, 6F5).
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the substantial evidence analysis, whether—as Savage says—“the medical
evidence, as set forth above, provided substantial evidence that [he] satisfied
the criteria of the relevant Listing,” Doc. 8, at 8, is irrelevant unless he shows
that substantial does not support the ALJ’s decision, see Warner v. Comm’r of
Soc. Sec., 375 F.3d 387, 390 (6th Cir. 2004). Savage has not made this showing.
Instead he makes the conclusory assertion that the ALJ’s decision lacked
support. Savage has thus forfeited the argument that the ALJ’s decision is
unsupported by substantial evidence. See McPherson v. Kelsey, 125 F.3d 989,
995–96 	(6th 	Cir. 	1997) 	(“[I]ssues 	adverted 	to 	in 	a 	perfunctory 	manner,
unaccompanied by 	some 	effort 	at 	developed argumentation, 	are 	deemed
waived. It is not sufficient for a party to mention a possible argument in the
most skeletal way, leaving the court to . . . put flesh on its bones.”).
In other words, Savage has not carried his burden to show that he met
or medically equaled Listing 4.12. Nor did he show that the ALJ’s assessment
that he failed to meet Listing 4.12 is unsupported by substantial evidence. So
Savage’s first issue does not provide a basis for remand.
2. 	The 	ALJ 	appropriately 	discussed 	how 	she 	considered 	the
supportability 	and 	consistency 	of 	Drs. 	Rehman’s 	and 	Sih’s
opinions.
Next, Savage argues that the “ALJ failed to address the supportability
and consistency of [Dr. Rehman’s] opinion. Thus, the ALJ’s rationale for
discounting the opinion of the treating source was either supported by nor
consistent with the evidence in this matter.” Doc. 8, at 13. He also claims that
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the “ALJ failed to address the supportability and consistency of [Dr. Sih’s]
opinion. Once again, the ALJ’s analysis of a treating source opinion was
neither supported by nor consistent with any evidence.” Id.
As an initial matter, to the extent that Savage is attempting to argue
that regulations require the ALJ discuss the supportability and consistency of
her own opinions, he has misread the applicable regulation. See Doc. 8, at 13
(asserting that the “ALJ’s analysis” was “neither supported by nor consistent
with any evidence”); 20 C.F.R. § 416.920c(b)(2) (requiring an ALJ consider the
supportability and consistency of medical opinion evidence). Instead, for
purposes of this Court’s review, the ALJ’s conclusions need only be supported
by substantial evidence. Biestek, 587 U.S. at 99. Additionally, to the extent that
Savage is attempting to distinguish Drs. Rehman’s and Sih’s opinions as
“treating source” opinions, that language invokes the former treating physician
rule. Under 20 C.F.R. § 416.927(c)(2), known as the “treating physician rule,”
when considering an application filed before March 27, 2017, the ALJ must
give a treating-source opinion controlling weight if the opinion is “well-
supported 	by 	medically 	acceptable 	clinical 	and 	laboratory 	diagnostic
techniques and not inconsistent with the other substantial evidence in the case
record.” 20 C.F.R. § 416.927(c)(2); Wilson v. Comm’r of Soc. Sec., 378 F.3d 541,
544 (6th Cir. 2004). And ALJs applying the former rule must provide “good
reasons” for the weight they give to treating physicians’ opinions. 20 C.F.R. §
416.927(c)(2). But the treating-physician rule does not apply to applications,
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such as Savage’s application, that were filed after March 27, 2017, and the
current regulations do not assign controlling weight to treating physicians’
opinion.
Under the current regulations, the Commissioner is required to evaluate
the 	persuasiveness 	of 	all 	medical 	opinions 	using 	the 	following 	factors:
supportability; 	consistency; 	treatment 	relationship, 	including 	the 	length,
frequency, purpose, and extent; specialization; and other factors. 20 C.F.R. §§
416.920c(a), 416.920c(c)(1)–(5). Supportability and consistency are the most
important factors. 20 C.F.R. § 416.920c(a). Supportability means 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[] …
the more persuasive the medical opinions … will be.” 20 C.F.R. § 416.920c(c)(1).
Consistency means “[t]he more consistent a medical opinion[] … is with the
evidence from other medical sources and nonmedical sources in the claim, the
more persuasive the medical opinion[] … will be.” 20 C.F.R. § 416.920c(c)(2).
The Commissioner must explain the supportability and consistency factors
when discussing a medical opinion. 20 C.F.R. § 416.920c(b)(2). “[A]n ALJ need
not,” however, “specifically use the terms ‘supportability’ or ‘consistency’ in his
analysis.” Cormany v. Kijakazi, No. 5:21-cv-933, 2022 WL 4115232, at *3 (N.D.
Ohio Sept. 9, 2022) (citing cases). The Commissioner is not required to discuss
the remaining factors. Id. “A reviewing court evaluates whether the ALJ
properly considered the factors as set forth in the regulations to determine the
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persuasiveness of a medical opinion.” Toennies v. Comm’r of Soc. Sec., 2020 WL
2841379, at *14 (N.D. Ohio June 1, 2020) (internal quotation marks and
citation omitted).
Here 	the 	ALJ 	appropriately 	considered 	the 	supportability 	and
consistency of both Dr. Rehman’s and Dr. Sih’s opinions as required by the
governing regulations. See Tr. 23–24.
As to her consideration of Dr. Rehman’s opinion, the ALJ explained as
follows:
I find little persuasive effect in the opinion of Dr.
Saif Rehman M.D., who stated the claimant could sit
for one to five minutes at one time, can stand for one
to five minutes at one time, can sit, stand, and walk
for less than two hours total in a eight hour workday,
requires periods of walking around to alleviate pain,
requires a cane for walking, can rarely lift less than
ten pounds, is incapable of even low stress work, and
is not able to work (7F1-4). Dr. Rehman’s opinion is
not well supported by a reasoned narrative, and
appears overly reliant on the claimant’s subjective
statements from treatment history. Dr. Rehman’s
opinion 	also 	is 	inconsistent 	with 	the 	repeatedly
normal 	diagnostic 	studies 	since 	February 	2023,
showing 	no 	occlusive 	disease 	in 	either 	lower
extremity (e.g., 6F5, 9F6). Dr. Rehman’s opinion is
also inconsistent with the record on its face because
his indicated total time in a seated or standing
position indicates the claimant is up and down every
five minutes or so, and would have to spend a good
majority 	of 	the 	day 	lying 	down. 	Clinical
examinations and general indications from medical
appointments indicate the claimant is able to sit and
stand 	for 	longer 	periods 	than 	indicated 	by 	Dr.
Rehman (e.g., 6F8, 9F444). There is no mention in
the treatment record of the claimant presenting for
appointments having to get in and out of his seat as
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often as Dr. Rehman has indicated. For the above
reasons, I find little persuasive effect in this opinion.
Tr. 23–24.
Here, the face of the ALJ’s decision belies Savage’s argument because
the ALJ specifically stated that she considered both the supportability and
consistency of Dr. Rehman’s opinion and the content of the ALJ’s decision
confirms she did as she stated. See Tr. 23–24. Savage’s statement that the ALJ
discounted Dr. Rehman’s opinion as having “little persuasive effect as there
was no mention of [him] presenting for appointments and having to ‘get in and
out of his seat as often’ as Dr. Rehman indicated[,]” Doc. 8, at 12 (citing Tr. 23–
24), oversimplifies the ALJ’s analysis. As to the supportability of Dr. Rehman’s
opinion the ALJ explained that she found it “not well supported by a reasoned
narrative; and appears overly reliant on the claimant’s subjective statements
from treatment history.” Tr. 23. By explaining that she found that the
underlying objective evidence and explanations that Dr. Rehman provided in
the opinion “had little persuasive effect,” id., the ALJ showed that she
considered the supportability factor. See 20 C.F.R. § 404.1520c(c)(1).
As to consistency, the ALJ explained that Dr. Rehman’s opinion was
“inconsistent with the repeatedly normal diagnostic studies since February
2023[.]” Id. The ALJ also explained that she found that Dr. Rehman’s opinion
that Savage needed to change positions every five minutes or so and spend a
majority of the day lying down, was inconsistent with “clinical examinations
and general indications from medical opinions indicat[ing] the claimant is able
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to sit and stand for longer periods than indicated by Dr. Rehman.” Id. And the
ALJ highlighted that “[t]here is no mention in the treatment record of the
claimant presenting for appointments having to get in and out of his seat as
often as Dr. Rehman has indicated.” Id. at 24. The ALJ’s explanations all go to
the consistency factor because she was explained that Dr. Rehman’s opinion
was less persuasive since it did not align with the other evidence of record. See
20 C.F.R. § 404.1520c(c)(2).
Next, the ALJ explained her consideration of Dr. Sih’s opinion as follows:
I also find little persuasive effect in the opinion of
Dr. Marvin Sih M.D., who stated the claimant can
sit for at least six hours during a workday, can stand
and walk for ten to fifteen minutes for less than two
hours total during a workday, requires periods of
walking around every five minutes for five to ten
minutes, will experience two to three unscheduled
breaks each workday, will be off task ten to fifteen
percent of any given workday, is capable of low
stress work, and will be absent three to four days of
work per month (8F1-4). Dr. Sih has not provided
any specific support for his conclusion the claimant
will be absent from work three to four days per
month, 	or 	concerning 	the 	opined 	need 	for
unscheduled breaks. His statements concerning a
need 	for 	the 	claimant 	to 	alternate 	sitting 	and
standing every five minutes is inconsistent with the
record for the same reasons as discussed above, with
Dr. Rehman’s opinion. Clinical examinations have
not shown the claimant changing positions with
such frequency. Such have not shown significant
edema in the lower extremities since stents were
placed in each, respectively (e.g., 9F444). Dr. Sih’s
opinion 	also 	does 	not 	distinguish 	or 	specifically
address 	the 	multiple 	ultrasound 	studies 	since
February 2023 showing no occlusive arterial disease
in either lower extremity (e.g., 9F6). Given these
inconsistencies and the lack of support for some of
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the stated restrictions, I find little persuasive effect
in Dr. Sih’s opinion.
Tr. 24.
Again, the face of the ALJ’s decision contradicts Savage’s argument that
“[t]he ALJ failed to address the supportability and consistency of this opinion.”
See Doc. 8, at 13. As to the supportability of Dr. Sih’s opinion, the ALJ noted
that Dr. Sih did not provide “any specific support for his conclusion that
[Savage] will be absent from work three to four days per month, or concerning
the opined need for unscheduled breaks.” Tr. 24. This statement shows that
the ALJ considered how Dr. Sih supported his own conclusions with citation or
explanations in the opinion. See 20 C.F.R. § 404.1520c(c)(1). Likewise, the ALJ
showed that she considered how consistent Dr. Sih’s opinion compared to the
rest of the record evidence when she explained that “[c]linical examinations
have not shown the claimant changing positions with [the opined] frequency”
and that his opinion “does not distinguish or specifically address the multiple
ultrasound studies since February 2023 showing no occlusive arterial disease
in either lower extremity[.]” Id., see also 20 C.F.R. § 404.1520c(c)(2).
Simply 	put, 	the 	ALJ 	properly 	considered 	the 	supportability 	and
consistency 	of 	both 	opinions 	under 	the 	applicable 	regulations. 	Savage’s
protestations to the contrary only illustrate that his position amounts to
nothing more than a dispute over the ALJ’s weighing of the evidence. See Doc.
8, at 13 (claiming that the medical evidence does not support the ALJ’s
conclusions). But this Court does not reweigh the evidence; weighing the
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evidence is solely the ALJ’s duty. See 20 C.F.R. § 404.1520c(a) (explaining how
the ALJ will consider and weigh medical opinions and prior administrative
medical findings); see also Rottman v. Comm’r of Soc. Sec., 817 F. App’x 192,
196 (6th Cir. 2020 (“[T]his court does not weigh evidence, assess credibility, or
resolve conflicts in testimony—that’s the ALJ’s job.”) (citation omitted)).
As a final point, Savage’s final paragraph of this section appears to
invoke two arguments not properly presented in the heading to this argument.
See 	id. 	at 	13–14 	(arguing 	that 	the 	ALJ 	failed 	to 	provide 	a 	“coherent
explanation” of how she considered the record and failed to “incorporated the
stated limitations into the RFC”). Savage’s argument that the ALJ failed to
comply with two district court decisions is not persuasive and is presented in
a conclusory manner––unaccompanied by any explanation of how the ALJ
failed act in accord with the decisions cited. So the argument is forfeited See
McPherson v. Kelsey, 125 F.3d 989, 995–96 (6th Cir. 1997) (“[I]ssues adverted
to in a perfunctory manner, unaccompanied by some effort at developed
argumentation, are deemed waived. It is not sufficient for a party to mention
a possible argument in the most skeletal way, leaving the court to ... put flesh
on its bones.”) (internal citations omitted). Additionally, Savage’s passing
argument that the ALJ failed to include certain limitations in her RFC
determination is entirely distinct from his second issue that alleges failure to
comply 	with 	regulations 	governing 	the 	consideration 	of 	medical 	opinion
evidence. See Doc. 8, at 13–14. So that argument contravenes this Court’s
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order. See Doc. 4, at 4. Both of these arguments are thus improperly presented
and forfeited.
To review, the ALJ appropriately considered the opinion evidence. So
neither Savage’s second issue presented, nor the other attendant arguments in
this section, provide a basis to remand.
3. 	The ALJ complied with Social Security Ruling 16-3p.
In his third issue, Savage alleges that when the ALJ discounted his
subjective symptom complaints, she failed to comply with Social Security
Ruling 16-3p. See Doc. 8, at 16.
To 	evaluate 	the “intensity, 	persistence, 	and limiting 	effects 	of 	an
individual’s symptoms,” the ALJ considers medical evidence, the claimant’s
statements, other information provided by medical sources, and any other
relevant evidence in the record. See Soc. Sec. Ruling 16-3p, 2017 WL 5180304,
at *4 (Oct. 25, 2017); 20 C.F.R. § 404.1529. Other relevant evidence includes:
daily activities; the location, duration, frequency, and intensity of pain or
symptoms; 	precipitating 	and 	aggravating 	factors; 	the 	type, 	dosage,
effectiveness, 	and 	side 	effects 	of 	any 	medication; 	treatment, 	other 	than
medication, to relieve pain; any measures used to relieve pain; and “[o]ther
factors concerning … functional limitations and restrictions due to pain or
other symptoms.” 20 C.F.R. § 404.1529(c). “The ALJ need not analyze all seven
factors, but should show that he considered the relevant evidence.” Hatcher v.
Berryhill, No. 1:18-cv-1123, 2019 WL 1382288, at *15 (N.D. Ohio Mar. 27,
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2019) (citing Cross v. Comm’r of Soc. Sec., 373 F. Supp. 2d 724, 733 (N.D. Ohio
2005)).
The sole argument indicated in the heading for Savage’s third issue is
that the ALJ failed to comply with SSR 16-3p when evaluating the totality of
his symptoms. See Doc. 8, at 14. To this end, Savage states “the ALJ is to
consider a person’s daily activities, the location and duration and frequency
and intensity of pain, the effects of medication, treatment received, and
measures other than treatment used for pain, and other factors concerning a
person’s functional limitations.” Id. At no point, however, does Savage point to
a particular factor or factors that the ALJ allegedly did not consider. See id at
14–18. Instead, Savage makes three conclusory assertions in support of his
third issue: (1) the ALJ failed to articulate any supportable rationale for her
finding that his subjective complaints were inconsistent with the medical
evidence; (2) the ALJ’s decision was “not sufficiently specific to make clear to
the individual and to any subsequent reviews the weight the ALJ gave to
[Savage] and/or the remainder of the evidence in this matter[;]” and, (3) the
ALJ’s conclusions were not supported by substantial evidence. Doc. 8, at 17. As
an overarching problem, Savage fails to cite any evidence to support his
conclusory assertions that the ALJ provided inadequate explanations or that
her decision was unsupported by substantial evidence. Id. By simply making
statements untethered to any record support, Savage has forfeited these
arguments. See McPherson, 125 F.3d at 995.
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But, even if Savage had attempted to substantiate his assertions with
factual support or pointed to particular factors that he felt the ALJ failed to
consider or discuss, the ALJ’s decision would contradict that argument. See Tr.
21 (identifying Savage’s difficulty with performing certain daily activities and
testimony related to difficult grocery shopping and alleged need elevate his
legs each day); Tr. 22 (summarizing Savage’s various conditions and prescribed
medications and treatment). Plus, to the extent that Savage is attempting to
argue that the ALJ’s failed to discuss certain factors listed in SSR 16-3p, that
ruling does not impose a requirement that the ALJ discuss all factors listed in
the Ruling. See Hatcher, 2019 WL 1382288, at *15.
As a final observation, Savage’s failure to provide specific examples from
the ALJ’s decision to demonstrate the deficiencies alleged and the conclusory
nature 	of 	his 	arguments 	indicate 	that 	Savage’s 	third 	issue 	ultimately
challenges 	the 	ALJ’s 	weighing 	of 	the 	evidence. 	In 	other words, 	Savage
essentially asks the Court to reweigh the evidence. This conclusion is partly
supported by the fact that Savage cites a great deal of factual evidence, some
of which is presented for the first time in this portion of his argument. See Doc.
8, at 14–16. This newly cited evidence is thus presented in breach of the Court’s
initial order and cannot provide support for Savage’s third issue. See Doc. 4, at
3–4. Further, Savage makes the following overarching statement summarizing
his third issue: “the totality of the evidence documenting [his] disabling
symptoms were ignored and/or disregarded by the ALJ, there was insufficient
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analysis, and [the] ALJ did not comply with the requirements of SSR 16-3p.”
Doc. 8, at 17–18. This statement makes clear that the apparent objective of his
third issue is for this Court to reweigh certain evidence and reach a conclusion
that aligns with Savage’s desired outcome. But that is not the role of this Court.
As noted, the ALJ is responsible for weighing the evidence. See 20 C.F.R. §
404.1520c(a). And simply pointing to evidence that Savage believe shows his
subjective symptom complaints should have been found more persuasive
neither shows that the ALJ erred in evaluating the evidence, nor that the ALJ’s
decision is unsupported by substantial evidence. See, e.g., Key, 109 F.3d at 273
(“The decision of an ALJ is not subject to reversal, even if there is substantial
evidence in the record that would have supported an opposite conclusion, so
long as substantial evidence supports the conclusion reached by the ALJ.”).
For all of the reasons stated, Savage’s third issue does not support
remand.
4. 	The ALJ’s RFC determination providing a limitation for Savage
to 	use 	a cane 	for 	ambulation 	was supported 	by 	substantial
evidence.
As his fourth and final issue section, Savage argues that the ALJ erred
by including a cane limitation only for walking rather than for both standing
and walking. Doc. 8, at 18–19. Savage points to the opinions of Drs. Rehman
and Sih to support this argument. Id. at 19. As is discussed, while Drs. Rehman
and Sih arguably indicated that Savage required the use of a cane when
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standing and walking, Tr. 620, 624, neither of these unpersuasive opinions nor
Savage’s arguments provide a basis to remand.
If an assistive device is “not a necessary device for [a] claimant’s use, it
cannot be considered an exertional limitation that reduce[s] [the claimant’s]
ability to work.” Carreon v. Massanari, 51 F. App’x 571, 575 (6th Cir. 2002). To
be considered a restriction or limitation, an assistive device “must be so
necessary that it would trigger an obligation on the part of the Agency to
conclude that the [device] is medically necessary.” Murphy v. Astrue, No. 2:11-
cv-114, 2013 WL 829316, at *10 (M.D. Tenn. March 6, 2013) (citations omitted).
To be medically necessary, the record must reflect “more than just a subjective
desire on the part of the plaintiff as to the use of a[n] [assistive device].” Id.
(citation omitted). And there must be medical documentation “describing the
circumstances for which it is needed (i.e., whether all the time, periodically, or
only in certain situations; distance and terrain; and any other relevant
information).” Soc. Sec. Ruling 96-9p, 1996 WL 374185, *7 (S.S.A. July 2,
1996); see Golden v. Berryhill, No. 1:18-cv-636, 2018 WL 7079506, at *19 (N.D.
Ohio 	Dec. 	12, 	2018) 	(“a 	cane 	prescription 	[that] 	does 	not 	indicate 	‘the
circumstances 	for 	which 	[the 	cane] 	is 	needed,’ 	… 	does 	not 	fulfil 	the
requirements under SSR 96-9p”), report and recommendation adopted sub
nom. Golden v. Comm’r of Soc. Sec., 2019 WL 415250 (N.D. Ohio Feb. 1, 2019).
“If the ALJ does not find that such device would be medically necessary,
then the ALJ is not required to pose a hypothetical to the V[ocational] E[xpert]”
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which includes the use of an assistive device. Murphy, 2013 WL 829316, at *10
(citing Casey v. Sec’y of Health & Human Servs., 987 F.2d 1230, 1235 (6th Cir.
1993)). Generally, an ALJ’s finding that an assistive device is not medically
necessary is error when the claimant was prescribed an assistive device and
the ALJ didn’t include the use of the device in the RFC without providing an
explanation for omitting it. Cruz-Ridol v. Comm’r of Soc. Sec., No. 1:17-cv-
1075, 2018 WL 1136119, at *15 (N.D. Ohio Feb. 12, 2018) (citing Watkins v.
Comm’r of Soc. Sec., No. 1:16-cv-2643, 2017 WL 6419350, at *11 (N.D. Ohio
Nov. 22, 2017)), report and recommendation adopted, 2018 WL 1083252 (N.D.
Ohio Feb. 28, 2018).
In support of his argument that his RFC should have included a
limitation for cane use for both ambulation and standing, Savage points to the
following evidence: (1) his testimony; (2) “observations and opinions of the
treating sources” Dr. Rehman and Dr. Sih, who he claims “indicated that [he]
required the use of a cane for both standing and walking; and (3) the vocational
expert’s testimony. See Doc. 8, at 19.
To find that a “hand-held assistive device is medically required, there
must be medical documentation establishing the need for a hand-held assistive
device to aid in walking or standing, and describing the circumstances for
which it is needed.” SSR 96-9p, 1996 WL 374185, at *7. To show that an
assistive device must have been required, a claimant “must also show that his
medical records specifically document the circumstances in which he required
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an assistive device—i.e., whether he required one at all times, during all
activities, and on all terrains.” Barnes v. Comm’r of Soc. Sec., No. 5:21-CV-
01688-JDA, 2023 WL 2988346, at *8 (N.D. Ohio Mar. 22, 2023) (emphasis
added); see SSR 96-9p, 1996 WL 374185, at *7.
Here, although Savage points to the opinions from Drs. Rehman and
Sih, he does not point to any evidence from those providers or any other
medical source that “specifically document[s] the circumstances in which he
required an assistive device” such that Ruling 96-9p required the ALJ to
discuss the use of a hand-held device. See Barnes, 2023 WL 2988649, at * 8.
Indeed, neither of the cited opinions described the circumstances in
which he required a can. For example, Dr. Rehman checked a box indicating
“Yes” that Savage needed a cane. Tr. 620. Then, in response to the questions
“Does your patient need a cane or other hand-held assistive device for walking,
standing or both?” and “Does your patient need a cane or other hand-held
assistive device all of the time?” Dr. Rehman simply wrote “Yes”––without
further narrative explanation. Id. Similarly, Dr. Sih indicated that “Yes”
Savage needed a cane. Tr. 624. In response to the same two questions, Dr. Sih
indicated, without further explanation, that Savage needed a cane for “Both”
walking and standing but that “No” he does not need a cane all of the time. Id.
These two opinions do not “show that his medical records specifically document
the circumstances in which he required an assistive device—i.e., whether he
required one at all times, during all activities, and on all terrains.” 2023 WL
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2988649, 	at 	*8 	(emphasis 	added). 	Additionally, 	these 	opinions 	reached
different conclusions as to whether Savage needed a cane at all times. Compare
Tr. 620 (Dr. Rehman stating that “Yes” he needed a cane at all times), with Tr.
624 (Dr. Sih stating that “No” he did not need a cane at all times). Savage
makes no attempt to reconcile this inconsistency and instead relies on these
two opinions as if they are one in the same. See Doc. 8, at 18. Savage also does
not point to any evidence that he had a prescription for a cane. The fact that
Savage references his own testimony or the vocational expert’s testimony also
does not show that a cane was medically necessary. See Parrish v. Berryhill,
No. 16-cv-1880, 2017 WL 2728394, at *12 (N.D. Ohio June 8, 2017) (“While
there are some indications in the medical records that Plaintiff was using a
cane, this is insufficient to establish that the cane was medically required”),
report and recommendation adopted, 2017 WL 2720332 (N.D. Ohio June 23,
2017).
Perhaps an even greater flaw in Savage’s final argument is that the ALJ
explicitly found that Drs. Rehman’s and Sih’s opinions, the only opinion
evidence that Savage cites to support his need for a cane, were unpersuasive.
Tr. 23–24. As explained above, the ALJ’s rational for finding Drs. Rehman’s
and Sih’s opinions unpersuasive complied with applicable regulations. Savage
does not address how the ALJ’s finding that Drs. Rehman and Sih’s opinions
were unpersuasive affects the ALJ’s evaluation of whether Savage required a
cane. Nor does he point to anything that would support an argument that the
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ALJ erred by omitting a limitation only supported by an opinion that she found
unpersuasive.
So Savage’s fourth issue does not provide a basis for remand.
Conclusion
For 	the 	reasons 	explained 	above, 	the 	Commissioner’s 	decision 	is
affirmed.
IT IS SO ORDERED.
Dated: December 4, 2025 	/s/ James E. Grimes Jr.
James E. Grimes Jr.
U.S. Magistrate Judge
Case: 5:25-cv-00762-JEG Doc #: 12 Filed: 12/04/25 32 of 32. PageID #: <pageID>