Case Name in Social Security Case - Unavailable

IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF PENNSYLVANIA
JENNIFER JACOBSEN, 	: Civil No. 1:25-CV-303
:
Plaintiff, 	:
:
v. 	:
: (Chief Magistrate Judge Bloom)
FRANK BISIGNANO, 	:
Commissioner of Social Security,1 	:
:
Defendant. 	:
MEMORANDUM OPINION
I. 	Introduction
Jennifer Jacobsen filed an application under Titles II and XVI of
the Social Security Act for disability and disability insurance benefits and
supplemental security income on July 7, 2022. 	Following a hearing
before 	an 	Administrative 	Law 	Judge 	(“ALJ”), 	the 	ALJ 	found 	that
Jacobsen was not disabled from her alleged onset date of August 31, 2021,
through April 10, 2024, the date of the ALJ’s decision.
1 	Frank 	Bisignano 	became 	the 	Commissioner 	of 	Social 	Security 	on
May 7, 2025. Pursuant to Rule 25(d) of the Federal Rules of Civil
Procedure 	and 	42 	U.S.C. 	§ 	405(g), 	Bisignano 	is 	substituted 	as 	the
defendant in this suit.
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Jacobsen now appeals this decision, arguing that the ALJ’s decision
is not supported by substantial evidence. 	After a review of the record,
and mindful of the fact that substantial evidence “means only—‘such
relevant evidence as a reasonable mind might accept as adequate to
support a conclusion,’” 2 we conclude that substantial evidence supports
the ALJ’s findings in this case. 	Therefore, we will affirm the decision of
the Commissioner denying this claim.
II. 	Statement of Facts and of the Case
Jennifer 	Jacobsen 	filed 	for 	disability 	and 	disability 	insurance
benefits, as well as supplemental security income, alleging disability due
to an aortic valve replacement, pace maker, heart issues since infancy,
calcium buildup in her shoulders, migraines, low platelets, and issues
with her cervical spine.3 	Jacobsen was 50 years old at the time of her
amended alleged onset of disability and had no past relevant work. 4
2
Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019).
3 Tr. 66.
4 Tr. 35.
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The medical record regarding Jacobsen’s impairments 5 revealed
that Jacobsen treated for headaches and thrombocytopenia prior to the
amended onset date of disability. 6 	In August of 2021, Jacobsen had an
oncology follow up appointment, at which time she complained of joint
pain. 7 	It was noted that her thrombocytopenia was asymptomatic. 8
Jacobsen was seen by Certified Registered Nurse Practitioner (“CRNP”)
Gabriela Hogan in October for her annual examination. 9 	Jacobsen
reported she was in good health and was completing daily home workouts
and gardening. 10 	CRNP Hogan noted Jacobsen’s chronic numbness and
tingling in her bilateral arms, but Jacobsen did not want medications at
that time. 11 	A physical examination revealed normal range of motion, a
negative Phalen’s test, and numbness and tingling in fingers after raising
5 While we have considered the records that pre-date the amended onset
date of disability, our discussion focuses primarily on the records relevant
to the alleged disability period.
6 Tr. 2060, 2065.
7 R. 2055.
8 Tr. 2058.
9 Tr. 2052-53.
10 Tr. 2053.
11
Id.
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her arms above her head for one minute. 12 	Hogan ordered an x-ray of
Jacobsen’s cervical spine. 13 	Hogan also noted Jacobsen’s history of two
prior heart surgeries and a chronic murmur and advised her to consider
a cardiology consultation. 14
In December of 2021, Jacobsen was diagnosed with severe aortic
stenosis, and she underwent an aortic valve replacement.15 	She also
required a post-operative pacemaker placement due to a heart block. 16
She was discharged in stable condition after roughly one week in the
hospital. 17 	At a two-week follow up appointment in January of 2022,
Jacobsen reported she was doing well and planned to start cardiac
rehabilitation. 18
In April, Jacobsen complained of dizziness and fatigue after she
tried to do yardwork. 19 	At a later visit in April, Jacobsen reported arm
12 Tr. 2054.
13 Tr. 2055.
14 Tr. 2054.
15 Tr. 725
16 Tr. 665-66.
17 Tr. 669.
18 Tr. 1953.
19 Tr. 1937.
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and shoulder pain, as well as weakness, that made her daily activities
difficult. 20 	It 	was 	noted 	that 	Jacobsen’s 	migraines 	had 	decreased
significantly since starting Topamax.21 	Regarding her shoulder pain,
Jacobsen reported worsening pain that radiated down her bilateral
arms. 22 	A physical examination revealed decreased range of motion in
both shoulders and an inability to reach behind her. 23 	CRNP Hogan
ordered an x-ray, noting that she suspected adhesive capsulitis due to the
heart 	surgery 	and 	recommended 	a 	course 	of 	physical 	therapy. 24
Jacobsen’s migraines were noted to be stable on Topamax. 25 The x-ray of
Jacobsen’s shoulders revealed adhesive capsulitis. 26
Jacobsen began physical therapy in April and reported trouble
reaching overhead and behind her back. 27 She exhibited limited range of
motion and impaired physical strength, which she reported decreased her
20 Tr. 1934.
21
Id.
22 Tr. 1935.
23 Tr. 1935-36.
24 Tr. 1936.
25
Id.
26 Tr. 2242-43.
27 Tr. 1931.
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abilities to perform activities of daily living. 28 At a follow up appointment
with CRNP Hogan in June, Jacobsen reported that physical therapy was
decreasing her overall pain. 29 	Hogan assessed that the chronic adhesive
capsulitis was improving and advised her to continue with physical
therapy. 30 	In 	July, 	it 	was 	noted 	that 	Jacobsen 	missed 	a 	therapy
appointment due to sore shoulders after helping her father move.31
Physical therapy notes from August and September of 2022 indicate
that Jacobsen was still experiencing pain and decreased range of motion,
but that therapy was slowly improving her condition. 32 During this time,
treatment notes indicated that Jacobsen engaged in activities such as
gardening and household chores. 33 	By October, Jacobsen completed
physical therapy but reported that her condition did not totally improve,
as she still had limited range of motion.34 	She declined injections or a
prednisone taper at this visit, and she was advised to consult with
28 Tr. 1932.
29 Tr. 1925.
30 Tr. 1926.
31 Tr. 2437.
32 Tr. 2412
33 Tr. 2418, 2432.
34 Tr. 2410.
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orthopedics. 35 	In November, Jacobsen continued to report difficulty
reaching overhead, and her provider encouraged her to move and stretch
more frequently but noted that injections or surgery could be an option
in the future. 36
In April of 2023, Jacobsen presented for her annual examination
and follow up for her migraines and complaints of dizziness.37 	Her
migraines were noted to be stable with medications, and she inquired
about medical marijuana for complaints of anxiety. 38 Jacobsen was noted
to have low blood pressure, which CRNP Hogan explained was likely the
cause of her dizzy spells and advised her to change positions slowly. 39
However, Jacobsen did not want to take blood pressure medications.40
In June, Jacobsen continued to complain of dizziness and reported
several episodes during which she felt a spinning sensation and lack of
balance. 41 	She also reported daytime fatigue and numbness in her
35 Tr. 2411.
36 Tr. 2401, 2403.
37 Tr. 2940.
38 Tr. 2941.
39
Id.
40
Id.
41 Tr. 2645.
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hands. 42 	A physical examination at this visit was unremarkable.43 	She
further denied chest pain, shortness of breath, syncope, or leg swelling,
and it was noted her symptoms were consistent with vertigo. 44 	She was
also referred to a sleep study for suspected sleep apnea, as well as to
neurology for her complaints of numbness. 45 	At a cardiology follow up in
October, it was noted that Jacobsen never contacted neurology for a
consultation. 46
CRNP Hogan filled out a physical residual functional capacity
assessment for Jacobsen in December of 2023.47 	Hogan opined that
Jacobsen could occasionally lift less than 10 pounds; could sit for four
hours and stand and/or walk for two hours in an eight-hour workday;
would need to alternate sitting and standing; had no postural limitations;
and 	was 	limited 	to 	occasional 	reaching 	overhead 	with 	both 	upper
extremities but not limited in reaching any other direction. 48
42
Id.
43 Tr. 2647-48.
44 Tr. 2649.
45
Id.
46 Tr. 2676.
47 Tr. 3077-79.
48
Id.
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It is against the backdrop of this record that an ALJ held a hearing
on Jacobsen’s disability application on January 30, 2024.49 Jacobsen and
a Vocational Expert (“VE”) both appeared and testified at this hearing. 50
Following this hearing, on April 10, 2024, the ALJ issued a decision
denying Jacobsen’s application for disability benefits. 51 	The ALJ first
concluded that Jacobsen had not engaged in substantial gainful activity
since her alleged onset date of August 31, 2021.52 	At Step 2 of the
sequential analysis that governs disability claims, the ALJ found that
Jacobsen suffered from severe impairments of aortic valve stenosis status
post mechanical aortic valve replacement and pacemaker placement;
adhesive capsulitis; and cervical retrolisthesis.53 	At Step 3, the ALJ
concluded that none of these impairments met or equaled the severity of
a listed impairment under the Commissioner’s regulations.54
Between Steps 3 and 4, the ALJ then concluded that Jacobsen:
49 Tr. 43-64.
50
Id.
51 Tr. 22-42.
52 Tr. 27.
53
Id.
54 Tr. 29-30.
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[H]a[d] the residual functional capacity to perform light work
as 	defined 	in 	20 	CFR 	404.1567(b) 	and 	416.967(b) 	except
occasional balance, stoop, crouch, kneel, climb ramps and
stairs, but never on ladders ropes or scaffolds; never crawl;
occasional 	overhead 	reaching 	bilaterally, 	frequent 	other
directions; 	limited 	to 	frequent 	exposure 	to 	temperature
extremes of cold and heat, wetness, humidity, fumes, odors,
dusts gases and poor ventilation, vibrations, and hazards
including 	moving 	dangerous 	machinery 	and 	unprotected
heights; must have the option to transfer positions with stand
and walk intervals up to 30 minutes at a time, no limitation
on sitting, not off tasks when transferring. 55
In 	reaching 	this 	RFC 	determination, 	the 	ALJ 	considered 	the
objective medical record detailed above, the medical opinion evidence,
and Jacobsen’s reported symptoms. With respect to the medical opinion
evidence, 	the 	ALJ 	considered 	the 	opinions 	of 	the 	state 	agency
consultants, Drs. Manganiello and Cuozzo, and found these opinions
generally persuasive. 56 	These providers opined that Jacobsen could
perform a range of light work, including certain reaching limitations. 57
Specifically, these providers found that Jacobsen could occasionally reach
overhead and in different directions with her right upper extremity and
55 Tr. 30-31.
56 Tr. 34.
57 Tr. 72-76, 98-103.
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frequently with her left. 58 The ALJ found these particular limitations not
entirely persuasive. 59 	Rather, the ALJ specifically found CRNP Hogan’s
limitation to occasional overhead reaching but no restrictions in reaching
other directions to be more consistent with the record evidence, which
showed improvement in Jacobsen’s shoulder functioning. 60 Thus the ALJ
reasoned that she limited Jacobsen to occasional overhead reaching but
frequent reaching in all other directions. 61
With respect to the remainder of CRNP Hogan’s opinion, the ALJ
found this opinion partially persuasive.62 	The ALJ again reiterated that
the opinion’s reaching limitations were consistent with Hogan’s own
treatment notes and other medical evidence in the record. 63 	However,
the ALJ found Hogan’s more restrictive sitting, standing, walking, and
lifting limitations to be inconsistent with the longitudinal medical record,
58
Id.
59 Tr. 34.
60
Id.
61
Id.
62 Tr. 35.
63
Id.
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which included improvements with treatment, and with the state agency
consultants’ opinions.64
With 	respect 	to 	Jacobsen’s 	symptoms, 	the 	ALJ 	found 	that
Jacobsen’s statements concerning the intensity, persistence, and limiting
effects of her impairments were not entirely consistent with the medical
evidence. 65 	Jacobsen testified that she could not work due to her history
of heart surgeries, loss of energy, adhesive capsulitis, numbness in her
arms, and dizziness. 66 	While she testified she experienced lower back
pain, she reported that she did not receive treatment.67 	She further
reported issues with her neck, which she treated with physical therapy. 68
Jacobsen also testified to her history of migraines, which she reported
were well controlled with medication. 69 	She further reported doing
household chores but pacing herself due to her pain. 70
64
Id.
65 Tr. 31-34.
66 Tr. 48-50.
67 TR. 52.
68 Tr. 54.
69 Tr. 58.
70 Tr. 59.
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The ALJ ultimately found Jacobsen’s testimony to be inconsistent
with the objective clinical findings. 71 	The ALJ recounted the objective
medical evidence, including unremarkable physical examinations as well
as the documented symptoms of decreased range of motion and pain in
Jacobsen’s 	bilateral 	shoulders. 72 	She 	also 	noted 	the 	records 	that
indicated Jacobsen’s pain and range of motion improved with treatment,
including physical therapy. 73 	The ALJ further noted that Jacobsen
declined to follow some of the recommendations of her providers, such as
orthopedic and neurology referrals, and that she was encouraged by her
providers to be more active.74 	Finally, the ALJ considered Jacobsen’s
activities of daily living, which included light housework and yardwork
during 	the 	relevant 	period.75 	Ultimately, 	the 	ALJ 	concluded 	that
Jacobsen was not as limited as she alleged.
Having made these findings, the ALJ found at Step 4 that Jacobsen
had no past relevant work but found at Step 5 that she could perform the
71 Tr. 31-34.
72 Tr. 31-34.
73
Id.
74 Tr. 32.
75 Tr. 33.
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occupations of an order caller, office helper, and assembler of electrical
accessories.76 Accordingly, the ALJ found that Jacobsen had not met the
stringent standard prescribed for disability benefits and denied her
claim. 77
This appeal followed. 	On appeal, Jacobsen argues that the ALJ’s
decision is not supported by substantial evidence because he failed to
limit her to occasional reaching and failed to adequately consider her
symptoms. This case is fully briefed and is therefore ripe for resolution.
For the reasons set forth below, we will affirm the decision of the
Commissioner.
III. 	Discussion
A. Substantial Evidence Review – the Role of this Court
This Court’s review of the Commissioner’s decision to deny benefits
is limited to the question of whether the findings of the final decision-
maker are supported by substantial evidence in the record.78 	Substantial
76 Tr. 36.
77 Tr. 37.
78
See 42 U.S.C. §405(g);
Johnson v. Comm’r of Soc. Sec., 529 F.3d 198,
200 (3d Cir. 2008);
Ficca v. Astrue, 901 F. Supp. 2d 533, 536 (M.D. Pa.
2012).
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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.” 79 	Substantial evidence means less
than a preponderance of the evidence but more than a mere scintilla.80
A single piece of evidence is not substantial evidence if the ALJ
“ignores, 	or 	fails 	to 	resolve, 	a 	conflict 	created 	by 	countervailing
evidence.”81 	However, where there has been an adequately developed
factual record, substantial evidence may be “something less than the
weight of the evidence, and the possibility of drawing two inconsistent
conclusions from the evidence does not prevent [the ALJ’s decision] from
being supported by substantial evidence.” 82 	The court must “scrutinize
the record as a whole” to determine if the decision is supported by
substantial evidence. 83
79
Pierce v. Underwood, 487 U.S. 552, 565 (1988).
80
Richardson v. Perales, 402 U.S. 389, 401 (1971).
81
Mason v. Shalala, 994 F.2d 1058, 1064 (3d Cir. 1993) (quoting
Kent v.
Schweiker, 	710 	F.2d 	110, 	114 	(3d 	Cir. 	1983)) 	(internal 	quotations
omitted).
82
Consolo v. Fed. Maritime Comm’n, 383 U.S. 607, 620 (1966).
83
Leslie v. Barnhart, 304 F. Supp.2d 623, 627 (M.D. Pa. 2003).
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The Supreme Court has explained the limited scope of our review,
noting 	that 	“[substantial 	evidence] 	means—and 	means 	only—‘such
relevant evidence as a reasonable mind might accept as adequate to
support a conclusion.’”84 	Under this standard, we must look to the
existing 	administrative 	record 	to 	determine 	if 	there 	is 	“‘sufficient
evidence’ to support the agency’s factual determinations.”85 	Thus, the
question before us is not whether the claimant is disabled, but rather
whether the Commissioner’s finding that he or she is not disabled is
supported 	by 	substantial 	evidence 	and 	was 	based 	upon 	a 	correct
application of the law. 86
84
Biestek, 139 S. Ct. at 1154 (quoting
Consolidated Edison Co. v. NLRB,
305 U.S. 197, 229 (1938)).
85
Id.
86
See Arnold v. Colvin, No. 3:12-CV-02417, 2014 WL 940205, at *1 (M.D.
Pa. Mar. 11, 2014) (“[I]t has been held that an ALJ’s errors of law denote
a 	lack 	of 	substantial 	evidence”) 	(alterations 	omitted);
	Burton 	v.
Schweiker, 512 F. Supp. 913, 914 (W.D. Pa. 1981) (“The Secretary’s
determination as to the status of a claim requires the correct application
of the law to the facts”);
see also Wright v. Sullivan, 900 F.2d 675, 678
(3d Cir. 1990) (noting that the scope of review on legal matters is
plenary);
Ficca, 901 F. Supp. 2d at 536 (“[T]he court has plenary review
of all legal issues . . . .”).
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When conducting this review, we must remain mindful that “we
must not substitute our own judgment for that of the fact finder.” 87 Thus,
we cannot re-weigh the evidence. Instead, we must determine whether
there is substantial evidence to support the ALJ’s findings. 	In doing so,
we must also determine whether the ALJ’s decision meets the burden of
articulation necessary to enable judicial review; that is, the ALJ must
articulate the reasons for his decision.88 	This does not require the ALJ
to use “magic” words, but rather the ALJ must discuss the evidence and
explain the reasoning behind his or her decision with more than just
conclusory 	statements. 89 	Ultimately, 	the 	ALJ’s 	decision 	must 	be
accompanied by “a clear and satisfactory explication of the basis on which
it rests.” 90
87
Zirnsak v. Colvin, 777 F.3d 607, 611 (3d Cir. 2014) (citing
Rutherford
v. Barnhart, 399 F.3d 546, 552 (3d Cir. 2005)).
88
Burnett v. Comm’r of Soc. Sec. Admin., 220 F.3d 112, 119 (3d Cir. 2000).
89
See Diaz v. Comm’r of Soc. Sec., 577 F.3d 500, 504 (3d Cir. 2009)
(citations omitted).
90
Cotter v. Harris, 642 F.2d 700, 704 (3d Cir. 1981).
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B. Initial Burdens of Proof, Persuasion, and Articulation for the ALJ
To receive disability benefits under the Social Security Act, a
claimant must show that he or she is unable to “engage in any substantial
gainful activity by reason of any medically determinable physical or
mental impairment which can be expected to result in death, or which
has lasted or can be expected to last for a continuous period of not less
than 12 months.” 91 This requires a claimant to show a severe physical or
mental impairment that precludes him or her from engaging in previous
work or “any other substantial gainful work which exists in the national
economy.” 92 	To receive benefits under Title II of the Social Security Act,
a claimant must show that he or she is under retirement age, contributed
to the insurance program, and became disabled prior to the date on which
he or she was last insured. 93
91 42 U.S.C. §423(d)(1)(A); 42 U.S.C. §1382c(a)(3)(A);
see also 20 C.F.R.
§§404.1505(a), 416.905(a).
92 	42 	U.S.C. 	§423(d)(2)(A); 	42 	U.S.C. 	§1382c(a)(3)(B); 	20 	C.F.R.
§§404.1505(a), 416.905(a).
93 42 U.S.C. §423(a); 20 C.F.R. §404.131(a).
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In 	making 	this 	determination, 	the 	ALJ 	follows 	a 	five-step
evaluation. 94 	The 	ALJ 	must 	sequentially 	determine 	whether 	the
claimant: (1) is engaged in substantial gainful activity; (2) has a severe
impairment; (3) has a severe impairment that meets or equals a listed
impairment; (4) is able to do his or her past relevant work; and (5) is able
to do any other work, considering 	his or her age, education, work
experience and residual functional capacity (“RFC”).95
Between Steps 3 and 4, the ALJ must also determine the claimant’s
residual functional capacity (RFC). 	RFC is defined as “that which an
individual is still able to do despite the limitations caused by his or her
impairment(s).”96 	In making this assessment, the ALJ must consider all
the claimant’s medically determinable impairments, including any non-
severe impairments identified by the ALJ at step two of his or her
analysis. 97 	Our review of the ALJ’s determination of the plaintiff’s RFC
94 20 C.F.R. §§404.1520(a), 416.920(a).
9520 C.F.R. §§404.1520(a)(4), 416.920(a)(4).
96
	Burnett, 220 F.3d at 121 (citations omitted);
	see also 20 C.F.R. §
404.1545(a)(1).
97 20 C.F.R. §§404.1545(a)(2), 416.945(a)(2).
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is deferential, and that determination will not be set aside if it is
supported by substantial evidence. 98
The claimant bears the burden at Steps 1 through 4 to show a
medically 	determinable 	impairment 	that 	prevents 	him 	or 	her 	from
engaging in any past relevant work. 99 	If met, the burden then shifts to
the Commissioner to show at Step 5 that there are jobs in significant
numbers 	in 	the 	national 	economy 	that 	the 	claimant 	can 	perform
consistent 	with 	the 	claimant’s 	RFC, 	age, 	education, 	and 	work
experience. 100
With 	respect 	to 	the 	RFC 	determination, 	courts 	have 	followed
different paths when considering the impact of medical opinion evidence
on this determination. 	While some courts emphasize the necessity of
medical opinion evidence to craft a claimant’s RFC, other courts have
taken the approach that “[t]here is no legal requirement that a physician
have made the particular findings that an ALJ adopts in the course of
98
Burns v. Barnhart, 312 F.3d 113, 129 (3d Cir. 2002).
99
Mason, 994 F.2d at 1064.
100 20 C.F.R. §§404.1512(f), 416.912(f);
Mason, 994 F.2d at 1064.
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determining an RFC.” 101 	Additionally, in cases that involve no credible
medical opinion evidence, courts have held that “the proposition that an
ALJ must always base his RFC on a medical opinion from a physician is
misguided.” 102
Given these differing approaches, we must evaluate the factual
context 	underlying 	an 	ALJ’s 	decision. 	Cases 	that 	emphasize 	the
importance of medical opinion support for an RFC assessment typically
arise in the factual setting where well-supported medical sources have
found limitations to support a disability claim, but an ALJ has rejected
the medical opinion based upon an assessment of other evidence. 103
These cases simply restate the notion that medical opinions are entitled
to careful consideration when making a disability determination. On the
other hand, when no medical opinion supports a disability finding or
when an ALJ relies upon other evidence to fashion an RFC, courts have
routinely sustained the ALJ’s exercise of independent judgment based
101
Titterington v. Barnhart, 174 F. App’x 6, 11 (3d Cir. 2006);
see also
Biller v. Acting Comm’r of Soc. Sec., 962 F. Supp. 2d 761, 778–79 (W.D.
Pa. 2013).
102
Cummings v. Colvin, 129 F. Supp. 3d 209, 214–15 (W.D. Pa. 2015).
103
Biller, 962 F. Supp. 2d at 778–79.
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upon all the facts and evidence.104 	Ultimately, it is our task to
determine, 	considering 	the 	entire 	record, 	whether 	the 	RFC
determination is supported by substantial evidence. 105
C. Legal Benchmarks for the ALJ’s Assessment of Medical Opinions
For applications filed after March of 2017, the regulations require
ALJs to consider several factors to determine the persuasiveness of a
medical 	opinion: 	supportability, 	consistency, 	relationship 	with 	the
claimant, 	specialization, 	and 	other 	factors 	tending 	to 	support 	or
contradict a medical opinion. 106 	Supportability and consistency are the
two most important factors, and an ALJ must explain how these factors
were considered in his or her written decision. 107 	Supportability means
“[t]he 	more 	relevant 	the 	objective 	medical 	evidence 	and 	supporting
explanations . . . are to support his or her medical opinion(s) . . . . the
more persuasive the medical opinions . . . will be.”108 	The consistency
104
See Titterington, 174 F. App’x 6;
Cummings, 129 F. Supp. 3d at 214–
15.
105
Burns, 312 F.3d 113.
106 20 C.F.R. § 404.1520c(c).
107 20 C.F.R. §§ 404.1520c(b)(2), 416.920c(b)(2);
Blackman v. Kijakazi,
615 F. Supp. 3d 308, 316 (E.D. Pa. 2022).
108 20 C.F.R. §§ 404.1520c(c)(1), 416.920c(c)(1).
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factor focuses on how consistent the opinion is “with the evidence from
other medical sources and nonmedical sources.”109
While there is an undeniable medical aspect to the evaluation of
medical opinions, it is well settled that “[t]he ALJ – not treating or
examining physicians or State agency consultants – must make the
ultimate disability and RFC determinations.” 110 	When confronted with
several medical opinions, the ALJ can choose to credit certain opinions
over others but “cannot reject evidence for no reason or for the wrong
reason.” 111 Further, the ALJ can credit parts of an opinion without giving
credit to the whole opinion and may formulate a claimant’s RFC based
on different parts of different medical opinions, so long as the rationale
behind the decision is adequately articulated. 112 	On the other hand, in
cases 	where 	no 	medical 	opinion 	credibly 	supports 	the 	claimant’s
allegations, “the proposition that an ALJ must always base his RFC on a
medical opinion from a physician is misguided.” 113
109 20 C.F.R. §§ 404.1520c(c)(2), 416.920c(c)(2).
110
Chandler v. Comm’r of Soc. Sec., 667 F.3d 356, 361 (3d Cir. 2011).
111
Mason, 994 F.2d at 1066.
112
See Durden v. Colvin, 191 F. Supp. 3d 429, 455 (M.D. Pa. 2016).
113
Cummings, 129 F. Supp. 3d at 214–15.
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D. Legal 	Benchmarks 	for 	the 	ALJ’s 	Assessment 	of 	a 	Claimant’s
Alleged Symptoms
When evaluating lay testimony regarding a claimant’s reported
degree 	of 	pain 	and 	disability, 	the 	ALJ 	must 	make 	credibility
determinations. 114 	Our review of those determinations is deferential. 115
However, it is incumbent upon the ALJ to “specifically identify and
explain what evidence he found not credible and why he found it not
credible.” 116 	An ALJ should give great weight to a claimant’s testimony
“only when it is supported by competent medical evidence.” 117 	As the
Third Circuit has noted, while “statements of the individual concerning
his or her symptoms must be carefully considered, the ALJ is not required
to credit them.”118
114
See Diaz v. Comm’r, 577 F.3d 500, 506 (3d Cir. 2009).
115
Id.
116
Zirnsak v. Colvin, 777 F.3d 607, 612 (3d Cir. 2014) (citations omitted).
117
	McKean v. Colvin, 150 F. Supp. 3d 406, 415–16 (M.D. Pa. 2015)
(citations omitted).
118
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”).
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The Social Security Rulings and Regulations provide a framework
for evaluating the severity of a claimant’s reported symptoms. 119 	Thus,
the ALJ must follow a two-step process: first, the ALJ must determine
whether a medically determinable impairment could cause the symptoms
alleged; 	and 	second, 	the 	ALJ 	must 	evaluate 	the 	alleged 	symptoms
considering the entire administrative record.120
Symptoms such as pain or fatigue will be considered to affect a
claimant’s ability to perform work activities only if medical signs or
laboratory findings establish the presence of a medically determinable
impairment that could reasonably be expected to produce the alleged
symptoms. 121 	During the second step of this assessment, the ALJ must
determine whether the claimant’s statements regarding the intensity,
persistence, or limiting effects of his or her symptoms are substantiated
considering the entire case record. 122 This includes, but is not limited to,
medical 	signs 	and 	laboratory 	findings; 	diagnoses; 	medical 	opinions
119 20 C.F.R. §§ 404.1529, 416.929; SSR 16–3p.
120 SSR 16-3p.
121 20 C.F.R. §§ 404.1529(b), 416.929(b); SSR 16–3p.
122 20 C.F.R. § 404.1529(c), 416.929(c); SSR 16–3p.
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provided by treating or examining sources and other medical sources; and
information regarding the claimant’s symptoms and how they affect his
or her ability to work. 123
The Social Security Administration recognizes that individuals
may be limited by their symptoms to a greater or lesser extent than other
individuals with the same medical impairments, signs, and laboratory
findings. 124 	Thus, to assist in the evaluation of a claimant’s subjective
symptoms, the Social Security Regulations set forth seven factors that
may be relevant to the assessment of the claimant’s alleged symptoms. 125
These 	factors 	include: 	the 	claimant’s 	daily 	activities; 	the 	“location,
duration, frequency, and intensity” of the claimant’s pain or symptoms;
the type, dosage, and effectiveness of medications; treatment other than
medications; 	and 	other 	factors 	regarding 	the 	claimant’s 	functional
limitations. 126
123
Id.
124 SSR 16-3p.
125 20 C.F.R. §§ 404.1529(c)(3), 416.929(c)(3).
126
Id.
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E. The ALJ’s Decision is Supported by Substantial Evidence.
Our review of the ALJ’s decision denying an application for benefits
is significantly deferential. Our task is simply to determine whether the
ALJ’s decision is supported by substantial evidence in the record; that is
“only— ‘such relevant evidence as a reasonable mind might accept as
adequate to support a conclusion.’”127 	Judged against this deferential
standard of review, we conclude that substantial evidence supported the
ALJ’s decision in this case.
The plaintiff first asserts that the ALJ’s decision is not supported
by 	substantial 	evidence 	because 	the 	RFC 	limited 	her 	to 	occasional
overhead reaching and frequent reaching in other directions, rather than
occasional reaching in all directions. 128 Jacobsen asserts that the medical
evidence supported a limitation to occasional reaching, and that the ALJ
failed to explain her rationale for the limitation to frequent reaching. 129
She further argues that this error requires remand because a limitation
127
Biestek, 139 S. Ct. at 1154.
128 Doc. 16 at 7-10.
129
Id.
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to occasional reaching would have eroded the occupations identified by
the VE at the hearing. 130
We 	find 	this 	argument 	particularly 	unavailing, 	as 	the 	ALJ’s
decision clearly and explicitly explained why the ALJ limited Jacobsen to
occasional overhead reaching and frequent reaching in other directions.
The decision first recounted the medical records concerning Jacobsen’s
shoulder impairments, including the findings of decreased range of
motion and difficulty raising her arms. 	The ALJ also noted treatment
records 	that 	indicated 	physical 	therapy 	was 	improving 	Jacobsen’s
condition. 	Further, 	the 	ALJ 	discussed 	the 	medical 	opinions 	and
explained why she adopted certain limitations regarding Jacobsen’s
reaching capabilities. 	She explained that the state agency consultants’
opinions were not entirely persuasive, but that she found CRNP Hogan’s
limitations 	to 	be 	supported 	by 	Hogan’s 	treatment 	notes 	and 	the
remainder of the objective evidence. 131 	Thus, the ALJ’s decision clearly
130
Id.
131 The plaintiff’s argument that no medical opinion supports the RFC’s
reaching 	limitations 	is 	particularly 	disingenuous, 	since 	it 	was 	the
plaintiff’s 	own 	treating 	provider, 	CRNP 	Hogan, 	that 	opined 	that
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explains the basis for these reaching limitations and is supported by the
medical evidence in the record. While the plaintiff appears to rely on her
subjective symptoms to demonstrate that she was more limited, as we
will explain, the ALJ found the plaintiff’s testimony not entirely credible.
Accordingly, we find no error with the ALJ’s RFC limitation.
Further, the plaintiff’s contention that a limitation to occasional
reaching would have eroded the occupations identified by the VE is
explicitly belied by the hearing transcript. The ALJ posed two light work
hypotheticals 	to 	the 	VE 	that 	included 	the 	limitation 	to 	occasional
overhead reaching and frequent reaching in other directions, and the VE
identified three occupations that the individual could perform, including
an order caller, merchandise marker, and cafeteria attendant.132 	After
posing an additional hypothetical requiring a sit/stand option, the VE
testified that only the order caller position remained but identified other
light work jobs that were available, such as an office helper and electrical
Jacobsen could occasionally reach overhead but had no limitations in
reaching other directions.
132 Tr. 61.
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accessories assembler. 133 The ALJ then asked if those occupations would
remain if the individual was limited to occasional lateral and forward
reaching with the right upper extremity, to which the VE responded
those jobs would remain. 134 	While the plaintiff points out that the three
jobs identified requiring “frequent reaching” in the DOT’s definition, the
VE further explained at the hearing that the DOT does not address
overhead reaching or reaching certain directions, and that the testimony
was based on her experience.135 Counsel did not ask any questions of the
VE or object to the VE’s experience.
Given this testimony by the VE, we find the plaintiff’s argument
regarding 	her 	reaching 	limitations 	to 	be 	wholly 	without 	merit.
Accordingly, because we find no error with the RFC determination, a
remand is not required.
The plaintiff also contends that the ALJ erred in evaluating her
subjective testimony by relying on her ability to perform some daily
activities, 	improvement 	in 	her 	symptoms 	with 	treatment, 	and 	her
133 Tr. 61-62.
134 Tr. 62.
135 Tr. 63.
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providers’ recommendations to stay active. 136 	At the outset, we note that
a claimant’s daily activities and effects of treatment are factors that,
pursuant to the regulations, are relevant to the ALJ’s consideration of a
claimant’s symptoms. 137 	Moreover, as we have explained, the ALJ
thoroughly discussed and considered the objective medical evidence from
the 	relevant 	period, 	including 	the 	medical 	opinion 	evidence, 	which
indicated Jacobsen’s impairments improved with treatment. 	While the
plaintiff would have us reweigh the evidence in her favor, we are
prohibited from doing so. 138
Given that the ALJ considered all the evidence and adequately
explained the decision for including or discounting certain limitations as
established 	by 	the 	evidence, 	we 	find 	no 	error 	with 	the 	decision.
Therefore, under the deferential standard of review that applies to
136 Doc. 16 at 11-14.
137 20 C.F.R. §§ 404.1529(c)(3), 416.929(c)(3);
	see also, e.g.,
	Russo v.
Astrue, 421 F. App'x 184, 190 (3d Cir. 2011) (finding no error where the
ALJ considered the claimant’s activities of daily living and found the
claimant not entirely credible) (nonprecedential);
Skapely v. Colvin, 2015
WL 7351583, at *12 (M.D. Pa. Nov. 20, 2015) (affirming decision where
the ALJ considered effectiveness of treatment to conclude the claimant
was less than credible).
138
Zirnsak, 777 F.3d at 611.
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appeals of Social Security disability determinations, we conclude that
substantial evidence supported the ALJ’s evaluation of this case, and this
decision will be affirmed.
IV. 	Conclusion
For the foregoing reasons, the decision of the Commissioner in this
case will be affirmed, and the plaintiff’s appeal denied.
An appropriate order follows.
Submitted this 27th day of February 2026.
s/ Daryl F. Bloom
Daryl F. Bloom
Chief United States Magistrate Judge
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