Marquez v. Commissioner of Social Security

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IN THE UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF OHIO
EASTERN DIVISION
ALICEMARIE MARQUEZ,
Plaintiff,
v.
COMMISSIONER OF SOCIAL SECURITY,
Defendant,
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)
)
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)
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)
CASE NO. 1:25-CV-00293-CAB
JUDGE CHRISTOPHER A. BOYKO
UNITED STATES DISTRICT JUDGE
MAGISTRATE JUDGE
CARMEN E. HENDERSON
REPORT & RECOMMENDATION
I. Introduction
Plaintiff, Alicemarie Marquez (“Marquez” or “Claimant”), seeks judicial review of the
final decision of the Commissioner of Social Security denying her application for Supplemental
Security Income (“SSI”). This matter is before me pursuant to 42 U.S.C. §§ 405(g), 1383(c)(3),
and Local Rule 72.2(b). For the reasons set forth below, it is RECOMMENDED that the Court
OVERRULE Claimant’s Statement of Errors and AFFIRM the Commissioner’s decision.
II. Procedural History
On August 23, 2022, Marquez filed an application for SSI, alleging a disability onset date
of August 30, 2016. (ECF No. 7, PageID #: 43). The application was denied initially and upon
reconsideration, and Marquez requested a hearing before an administrative law judge (“ALJ”).
(Id.). 	On October 24, 2023, an ALJ held a hearing, during which Claimant, represented by
counsel and with the benefit of an interpreter, and an impartial vocational expert testified. (See
id. at PageID #: 73-99). On, March 13, 2024 the ALJ issued a written decision finding Marquez
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was not disabled. (Id. at PageID #: 43-69). The ALJ’s decision became final on December 30,
2024, when the Appeals Council declined further review. (Id. at PageID #: 27).
On February 14, 2025, Marquez filed her Complaint to challenge the Commissioner’s
final decision. (ECF No. 1.) The parties have completed briefing in this case. (ECF Nos. 8, 9).
Marquez asserts the following assignments of error:
(1) The ALJ erred when he failed to support and/or address consistency with his conclusions
regarding the opinions of the treating, examining, and reviewing sources.
(2) The ALJ erred when he failed to properly apply the criteria of Social Security Ruling 96-
8p and consider all Plaintiff’s impairments and related limitations when forming the
residual functional capacity evaluation.
(ECF No. 8 at 1).
III. Background
A. Relevant Medical Evidence
The ALJ summarized Marquez’s health records and symptoms:
Medical Evidence of Physical Impairments
The record supports that the claimant has 	experienced some
functional limitations related to fibromyalgia and obesity. The
record supports height, weights, and body mass index (“BMI”)
scores consistent with the diagnosis of obesity (see e.g., BMI of
36.09 (1F/50 (09/20/21)); BMI of 36.7 (2F/4 (12/17/22); BMI of
40.2 (7F/4 (08/22/23)).
The claimant’s diagnosis of fibromyalgia predates the relevant
period and is well documented in the record (e.g., 1F/4; 7F/2).
However, the evidence is sparse as to examination findings and
reports related to fibromyalgia. Between September of 2021 and
December of 2022, there are no remarkable examination findings
or reports. Rather, at the claimant’s September 2021 physical, her
provider note [sic] that she had not been seen in over a year, and
her examination was unremarkable (1F/50-51 (09/20/21)). At a
follow-up examination a few weeks later, the claimant reported
worsening fibromyalgia symptoms, and her provider discussed
changing her fibromyalgia medication depending upon interactions
with 	the 	claimant’s 	mental 	health 	medication 	(1F/48-49
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(10/07/21)). 	Otherwise, 	there 	are no 	records 	of 	examinations
related to the claimant’s physical impairments until December of
2022. At the claimant’s mental health examinations during that
time, she reported pain on only one occasion between September
of 2021 and October of 2022 (1F/42 (06/10/22) (reporting back
and joint pain at 4/10 severity); see generally 1F).
At a consultative examination on December 17, 2022, the claimant
attended with her mother and reported, among other things, pain,
swelling, numbness, dizziness, fatigue, shortness of breath, and
nausea from fibromyalgia (2F/2). The claimant also reported that
her fibromyalgia mainly impacted her bilateral shoulders and
hands in that she has pain and weakness (2F/6). On examination,
the claimant’s gait was steady and symmetric; her straight leg test
was negative; her sensation and reflexes were normal throughout;
she had tenderness in her cervical spine, thoracic spine, lateral
shoulders, and her acromioclavicular (AC) joint bilaterally; she
was able to lift, carry, and handle light objects; her fine and gross
manipulation were grossly normal (2F/5). She could squat and rise
with ease, could rise from sitting without assistance, and got up
and down from the exam table with ease. Her heel-toe walk and
tandem walking were normal. She could stand and hop on one foot
bilaterally. She had good range of motion in all of her extremities.
She had some weakness in her bilateral upper extremities, but her
lower 	extremities 	had 	normal 	strength, 	sensation, 	and 	motor
function, and she had good balance (2F/6, 8-13).
Several months later, the claimant reported to her therapist that she
had difficulty sleeping due to fibromyalgia (3F/17 (02/15/23);
3F/18 (02/22/23)). When the claimant had a routine follow-up with
her physician in March of 2023, she had not been seen for “some
time” 	prior; 	her 	medications 	were 	continued 	and 	she 	was
recommended 	for 	a 	follow-up 	in 	a 	few 	months 	(7F/11- 	15
(03/28/23)). About five months after that, the claimant visited her
provider to have paperwork for her claim filled out; she reported
that her fibromyalgia was worse in her bilateral hands and that she
had back pain; on examination, she had normal range of motion in
her spine; her mood, affect, and behavior were normal; and her
examination was otherwise unremarkable (7F/2-10 (08/22/23)).
…
Medical Evidence of Mental Impairments
The record supports that the claimant has experienced functional
limitations 	related 	to 	attentiondeficit 	hyperactivity 	disorder
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(“ADHD”), generalized anxiety disorder (“GAD”), adjustment
disorder, 	depressive 	disorder, 	borderline 	personality 	disorder,
social anxiety disorder, and borderline intellectual functioning
(“BIF”). The claimant has received specialized mental health
treatment, and she takes medication for her mental health. Overall,
the record supports that the claimant’s medication helps, and
therapy has improved the claimant’s symptoms.
The claimant underwent an assessment for ADHD in October of
2022. 	As 	part 	of 	that 	assessment, 	the claimant 	underwent 	a
Wechsler 	Adult 	Intelligence 	Scale 	(WAIS-IV) 	and 	Connors
Continuous Performance Test (CPT-3). The claimant’s WAIS-IV
and CPT-3 scores met the threshold for ADHD diagnosis, and
some of the claimant’s WAIS-IV scores also showed BIF (3F/3-5
(10/20/22)).
The claimant’s remarkable mental status examination findings and
reports include the following: in June of 2022, she reported doing
“ok” and having improvement in her depressive symptoms; she
also reported not having panic attacks but feeling increased anxiety
when out unaccompanied. During a telephone examination, the
claimant was cooperative; her speech was normal; her mood was
anxious; 	her 	attention 	and 	concentration 	were 	sustained; 	her
memory was within normal limits; and her judgment and insight
were fair. Her provider adjusted her mental health medication and
recommended continuing psychotherapy (1F/40-44 (06/10/22)).
During a counseling appointment that same day, the claimant was
cooperative; her speech was normal; her judgment and insight
were good; her memory was within normal limits; her attention
and concentration were sustained; her mood was euthymic; and her
affect was constricted (1F/38-40 (06/10/22)).
The claimant attended counseling throughout 2022, and her earlier
examinations show some remarkable findings. For example, in
June of 2022, the claimant reported that she would be attending an
event 	the 	next 	day 	with 	friends. 	On 	examination, 	she 	was
cooperative; her speech and thought processes were normal; her
judgment and insight were fair; her memory was within normal
limits; her attention was sustained; her fund of knowledge was
okay; her mood was euthymic and anxious; and her affect was full
range (1F/36-38 (06/17/22)). At her next appointment, her mood
was dysphoric and her affect was constricted, but her examination
was otherwise substantially similar (1F/34-36 (06/24/22)). The
claimant failed to attend her next several appointments (1F/34
(07/01/22; 07/08/22; 07/21/22)). When she resumed, the claimant
reported increasing anxiety and feeling unfocused; on examination,
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she was cooperative, her speech was normal; her thought process
was logical and organized; her judgment and insight were fair; her
memory was within normal limits; her attention was sustained; her
fund of knowledge was okay; her mood was euthymic; and her
affect was constricted (1F/32-33 (07/28/22)). There was also an
instance in which the claimant reported feeling depressed; on
examination, she was withdrawn; her speech was slowed; her
thought process was vague; her judgment and insight were fair; her
memory was normal; her attention was sustained; her fund of
knowledge was okay; her mood was depressed; and her affect was
constricted (1F/30-32 (08/04/22)). She later reported difficulty
identifying and experiencing emotions, as well as issues with
memory and focus; on examination, her thought process was
vague, her mood was dysphoric, and her affect was flat, but the
findings were otherwise unremarkable (1F/28-30 (08/11/22)). A
week 	later, 	her 	mood 	was 	dysphoric, 	and 	her 	affect 	was
constricted, 	but 	her 	examination 	was 	otherwise 	unremarkable
(1F/26-28 (08/18/22)).
The claimant reported to her mental health nurse practitioner that
she was doing “ok,” she had been coming out of her room more
often, and her depression was much better; she also reported
watching a game with eight other people a week before. During the
appointment, the claimant’s mother also reported that the claimant
was having difficulty with self-care and needing reminders to
attend to grooming. On examination, the claimant was cooperative,
her mood was anxious, and her judgment and insight were fair.
The nurse practitioner adjusted the claimant’s medication (1F/23-
26 (08/25/22)).
While the claimant’s reports to her counselor were sometimes
remarkable in the latter part of 2022, her examinations generally
were not, and the claimant began reporting improvements in her
mental health with continued therapy. The claimant reported her
mood was causing her to neglect her hygiene; on examination, she
was cooperative; her speech was normal; her thought process was
logical and organized; her judgment and insight were fair; her
memory 	was 	normal; 	her 	attention 	and 	concentration 	were
sustained; 	her 	fund 	of 	knowledge 	was 	okay; 	her 	mood 	was
euthymic, and her affect was full (1F/22-23 (08/26/22)). At her
next appointment, her mood was dysphoric, and her affect was
constricted, 	but 	her 	examination 	was 	otherwise 	unremarkable
(1F/20-21 (09/01/22)). The claimant reported looking forward to,
but also being nervous about, a gaming weekend; her mood was
euthymic, but her examination was otherwise substantially similar
(1F/18-20 (09/08/22)). She later reported a successful experience
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at a social event and improvements in self-care and hygiene; and
her examination was unremarkable (1F/16-18 (09/14/22)). The
claimant reported nerves and anxiety about attending an upcoming
public event; on examination, she was cooperative and restless; her
mood was euthymic; her affect was constricted; and the remainder
of her examination was unremarkable (1F/14-16 (09/22/22)). She
reported anxiety; and on examination, she was cooperative and
withdrawn; her speech was slowed; her thought process was
vague; her mood was dysphoric; and her affect was flat (1F/13- 14
(09/29/22)). The claimant reported avoiding an event because of
her anxiety, but her examination was unremarkable (1F/11-12
(10/12/22)). 	The 	claimant 	also 	reported 	having 	COVID 	and
canceling a recent event due to anxiety; on examination, her mood
was anxious, but the balance of the examination as unremarkable
(1F/8-10 (10/26/22)). About a month later, the claimant was
cooperative; her speech was normal; her thought processes were
logical and organized; her judgment and insight were good and
fair; her memory was normal; her attention and concentration were
sustained; 	her 	fund 	of 	knowledge 	was 	okay; 	her 	mood 	was
euthymic; and her affect was full range (7F/16-24 (11/23/22)).
At a consultative physical examination on December 17, 2022, the
claimant 	attended 	with 	her 	mother 	and 	reported 	depression,
difficulty sleeping, and crying spells. On examination, the claimant
was alert; she had good eye contact and fluent speech; her mood
was appropriate; she had clear thought processes; and her memory
and concentration were good (2F/5). She also was cooperative
(2F/6, 8-13).
The 	claimant 	also 	sought 	and 	underwent 	therapy, 	which
demonstrates significant improvement in her symptoms over time.
Initially, she reported increasing anxiety and a desire to change
medication (3F/7-8 (12/14/22)). But the claimant then reported
improved hygiene and motivation to apply for school (3F/15
(12/28/22)). She also reported that therapy techniques were helpful
and she had been more motivated to get things, like self-care, done
(3F/13 (01/04/23)). Throughout the course of therapy, the claimant
reported some anxiety (e.g., 3F/11 (01/17/23); 3F/17 (02/15/23);
6F/5 (09/06/23)), some lack of motivation to complete self-care
(e.g., 3F/11 (01/17/23)), and stress surrounding family events and
schooling 	(e.g., 	6F/27 	(06/24/23); 	6F/17 	(07/19/23); 	6F/13
(07/26/23); 6F/9 (08/23/23)). On one occasion, she also reported
increased 	depression, 	but 	she 	also 	reported 	not 	taking 	her
medication for the last few days (6F/43 (03/22/23)) and the issue
resolve 	[sic] 	with 	taking 	her 	medication 	regularly 	(6F/41
(03/29/23; 6F/35 (05/17/23)). Otherwise, the claimant reported
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lessening anxiety (e.g., 6F/31 (06/07/23)), improvement in her
sleep (e.g., 3F/10 (01/25/23); 6F/31 (06/07/23)), improvements in
her 	self-care 	and 	hygiene 	(e.g., 	3F/20 	(03/08/23); 	6F/31
(06/07/23)), and overall improvement in her thoughts or mood
(e.g., 3F/20 (03/08/23); 6F/5 (09/06/23); 6F/3 (09/13/23); 6F/1
(09/20/23)). Moreover, the claimant reported being able to be
social; for example, she went to a friend’s house and celebrated a
friend’s birthday even though she had been anxious, sad, and upset
(3F/18 (02/22/23)); she reported looking forward to spending time
with friends (3F/20 (03/08/23)); she attended Comicon with friends
despite 	anxiety 	(6F/41 	(03/29/23)); 	she 	attended 	a 	family
celebration 	(6F/29 	(06/21/23)); 	she 	reported 	improvements 	in
seeking out social situations (6F/15 (08/02/23)); she reported
feeling that she had progressed since starting therapy because she
could make her own calls, spend time with friends, and meet new
people, even though she felt anxious (6F/11 (08/09/23)); she
reported attending a social event despite being anxious (6F/7
(08/30/23)); she reported plans to attend a masquerade ball and a
family member’s wedding (6F/5 (09/06/23)). At a follow-up with
her nurse practitioner, the claimant reported decreased depression
(7F/1 (09/11/23)).
(ECF No. 7, PageID #: 54-57).
B. Opinion Evidence at Issue
In reaching his decision, the ALJ considered the previous opinions from the State agency
medical and psychological consultants; the opinion of consultative examiner Dr. Paul Oh; and
opinions from Plaintiff’s providers, including Dr. Francheska Caminero, Dr. Deborah A. Koricke
(with her interns Cynthia Cohen and Dr. Elyra Gonzalez), Margaret Onyeukwu, and Michael
Allen. 	(ECF No. 7, PageID #: 61-67). 	The ALJ’s discussion of the opinions is set forth in
greater detail below in conjunction with Plaintiff’s arguments.
IV. 	The ALJ’s Decision
The ALJ made the following findings relevant to this appeal:
1. 	The claimant has not engaged in substantial gainful activity since
August 23, 2022, the application date (20 CFR 416.971 et seq.).
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2. 	The claimant has the following severe impairments: fibromyalgia;
obesity; 	attention-deficit 	hyperactivity 	disorder 	(“ADHD”);
generalized 	anxiety 	disorder 	(“GAD”); 	adjustment 	disorder;
depressive disorder; borderline personality disorder; social anxiety
disorder; and borderline intellectual functioning (“BIF”) (20 CFR
416.920(c)).
3. 	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 416.920(d), 416.925 and 416.926).
4. 	After careful consideration of the entire record, the undersigned
finds that the claimant has the residual functional capacity to
perform light work as defined in 20 CFR 416.967(b) except she
can occasionally climb ladders, ropes, and scaffolds; she can
frequently reach overhead and frequently handle; she must avoid
hazards such as unprotected heights and moving machinery, but
she could avoid ordinary hazards in the workplace such as boxes
on the floor, doors ajar, or approaching people or vehicles; she is
limited to a static work environment where she would be able to
tolerate few changes in a routine work setting and when said
changes occur, any changes in job duties are explained; she can
perform simple tasks; she can perform routine and repetitive tasks;
she can have occasional interaction with coworkers; and she can
have 	occasional 	superficial 	interaction 	with 	public 	(where
superficial means that if a member of the public were to approach
to ask directions to the nearest restroom, she could provide such
information, but that would be the extent of the interaction).
…
9. 	Considering the claimant’s age, education, work experience, and
residual functional capacity, there are jobs that exist in significant
numbers in the national economy that the claimant can perform (20
CFR 416.969 and 416.969a).
10. The claimant has not been under a disability, as defined in the
Social 	Security 	Act, 	since 	August 	23, 	2022, 	the 	date 	the
application was filed (20 CFR 416.920(g)).
(ECF No. 7, PageID #: 45-46, 51, 68-69).
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V. Law & Analysis
A. Standard of Review
The Court’s review “is limited to determining whether the Commissioner’s decision is
supported by substantial evidence and was made pursuant to proper legal standards.” Winn v.
Comm’r of Soc. Sec., 615 F. App’x 315, 320 (6th Cir. 2015); see also 42 U.S.C. § 405(g).
“[S]ubstantial evidence is defined as ‘more than a scintilla of evidence but less than a
preponderance; it is such relevant evidence as a reasonable mind might accept as adequate to
support a conclusion.’” 	Rogers v. Comm’r of Soc. Sec., 486 F.3d 234, 241 (6th Cir. 2007)
(quoting Cutlip v. Sec’y of HHS, 25 F.3d 284, 286 (6th Cir. 1994)).
“After the Appeals Council reviews the ALJ’s decision, the determination of the council
becomes the final decision of the Secretary and is subject to review by this Court.” Olive v.
Comm’r of Soc. Sec., No. 3:06 CV 1597, 2007 WL 5403416, at *2 (N.D. Ohio Sept. 19, 2007)
(citing Abbott v. Sullivan, 905 F.2d 918, 922 (6th Cir. 1990); Mullen v. Bowen, 800 F.2d 535,
538 (6th Cir. 1986) (en banc)). If the Commissioner’s decision is supported by substantial
evidence, it must be affirmed, “even if a reviewing court would decide the matter differently.”
Id. (citing 42 U.S.C. § 405(g); Kinsella v. Schweiker, 708 F.2d 1058, 1059–60 (6th Cir. 1983)).
B. Standard for Disability
The Social Security regulations outline a five-step process that the ALJ must use in
determining whether a claimant is entitled to supplemental-security income or disability-
insurance benefits: (1) whether the claimant is engaged in substantial gainful activity; (2) if not,
whether the claimant has a severe impairment or combination of impairments; (3) if so, whether
that impairment, or combination of impairments, meets or equals any of the listings in 20 C.F.R.
§ 404, Subpart P, Appendix 1; (4) if not, whether the claimant can perform her past relevant
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work in light of her residual functional capacity (“RFC”); and (5) if not, whether, based on the
claimant’s age, education, and work experience, she can perform other work found in the
national economy. 20 C.F.R. § 416.920(a)(4)(i)–(v); Combs v. Comm’r of Soc. Sec., 459 F.3d
640, 642–43 (6th Cir. 2006). The claimant bears the ultimate burden of producing sufficient
evidence to prove that she is disabled and, thus, entitled to benefits. 20 C.F.R. § 416.912(a).
Specifically, the claimant has the burden of proof in steps one through four. Walters v. Comm’r
of Soc. Sec., 127 F.3d 525, 529 (6th Cir. 1997). The burden shifts to the Commissioner at step
five to establish whether the claimant has the residual functional capacity to perform available
work in the national economy. Id.
C. Discussion
Marquez raises two issues on appeal: 1) whether the ALJ erred when he failed to support
and/or 	address 	consistency 	with 	his 	conclusions 	regarding 	the 	opinions 	of 	the 	treating,
examining, and reviewing sources; and 2) whether the ALJ erred when he failed to properly
apply Social Security Ruling (“SSR”) 98-6p and consider all of Plaintiff’s impairments and
limitations when crafting the RFC. 	(ECF No. 8 at 1). 	In response, the Commissioner argues
Plaintiff has forfeited her arguments due to her failure to follow the requirements of the Court’s
initial order and Plaintiff’s challenges otherwise fail on the merits. (ECF No. 9 at 10-21).
1. 	Compliance with the Initial Order
Before addressing the merits of Plaintiff’s issues, the Commissioner argues Plaintiff has
waived her arguments because she failed to comply with the Court’s Initial Order. (ECF No. 9 at
10). 	The Commissioner asserts that the Initial Order required a statement of relevant facts
“supported by a specific reference to the transcript page number on which that fact is found” but
Plaintiff “failed to cite any objective medical evidence in her ‘Statement of Facts’ and repeatedly
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cited to facts in her argument that were not included in her ‘Statement of Facts.’” (Id.). Plaintiff
did not file a reply and therefore failed to respond to Defendant’s argument.
As Defendant correctly indicates, the Initial Order requires a statement of facts supported
with citations and cautions that “[a]ny fact in the transcript not referred to in a party’s Statement
of Relevant Facts may be deemed non-essential to the determination of the issues presented.”
(ECF No. 5 at 3). 	However, contrary to the Defendant’s representations, Plaintiff provides at
least a passing citation to each of the medical opinions she challenges. (See ECF No. 8 at 2-3).
While Plaintiff’s statement of facts would certainly have benefited from the inclusion of the
additional facts she cited later in her argument, the undersigned does not believe a finding of
waiver is warranted in this instance. 	Instead, Plaintiff’s counsel is cautioned that continued
future failure to include all relevant facts in her Statement of Facts may result in a finding of
waiver.
2. 	Consideration of Medical Opinions
Plaintiff’s first argument is that the ALJ failed to properly consider the medical opinions
in determining her RFC. (ECF No. 8 at 7).
At step four, the ALJ must determine a claimant’s RFC by considering all relevant
medical and other evidence. 	20 C.F.R. § 416.920(e). 	Under the current regulations, the SSA
“will not defer or give any specific evidentiary weight, including controlling weight, to any
medical opinion(s) or prior administrative medical finding(s).” 	20 C.F.R. § 416.920c(a).
Nevertheless, an ALJ must “articulate how [he] considered the medical opinions and prior
administrative medical findings” in adjudicating a claim. 	Id. 	Medical source opinions are
evaluated using the factors listed in 20 C.F.R. § 416.920c(c). The factors include: supportability;
consistency; the source’s relationship with the claimant; the source’s specialized area of practice,
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if any; and “other factors that tend to support or contradict a medical opinion.” 	20 C.F.R. §
416.920c(c). 	The ALJ is required to explain how he considered the supportability and
consistency of a source’s medical opinion, but generally is not required to discuss other factors.
20 C.F.R. § 416.920c(b)(2). 	Under the regulations, “[t]he more relevant the objective medical
evidence and supporting explanations presented by a medical source are to support his or her
medical opinion(s) or prior administrative medical finding(s), the more persuasive the medical
opinions or prior administrative medical finding(s) will be” and “[t]he more consistent a medical
opinion(s) or prior administrative medical finding(s) is with the evidence from other medical
sources and nonmedical sources in the claim, the more persuasive the medical opinion(s) or prior
administrative medical findings(s) will be.” 20 C.F.R. § 416.920c(c)(1)-(2).
a. 	Onyeukwu and Allen
Plaintiff first challenges the ALJ’s consideration of Mental Health Questionnaires
completed by Onyeukwu and Allen, arguing the ALJ “erroneously found that Plaintiff’s
condition improved regarding her anxiety and social interactions” but failed to consider that
Plaintiff “needed to create routines and not allow her anxiety to control her actions” and was
“attending counseling on a weekly basis.” (ECF No. 8 at 9-10). The Commissioner argues the
ALJ reasonably found these opinions unpersuasive and substantial evidence supports this
decision. (ECF No. 9 at 11-14).
The ALJ summarized the opinions and explained his consideration of them as follows:
The undersigned finds unpersuasive the opinions of the claimant’s
psychiatric health nurse practitioner, Margaret Onyeukwu, dated
June 	22, 	2022 	(1F/69-70), 	and 	her 	mental 	health 	counselor,
Michael Allen, LPCC-S, dated June 13, 2022 (1F/75-76). CNP
Onyeukwu opined that the claimant is either unable to meet
competitive 	standards 	or 	is 	seriously 	limited 	in 	all 	mental
functional 	areas 	except 	carrying 	out 	very 	short 	and 	simple
instructions. NP Onyeukwu further opined that the claimant is not
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able to sustain work and/or is unable to work. Similarly, counselor
Allen opined that the claimant is unable to meet competitive
standards with regard to maintaining attention and concentration
for extended periods, working in coordination with or in proximity
to others without being distracted by them, asking simple questions
or requesting assistance, and setting realistic goals or making plans
independently 	of 	others; 	that 	she 	has 	serious 	limitations 	in
completing a normal workday and workweek, performing at a
consistent pace without an unreasonable number and length of rest
periods; 	remembering 	locations 	and 	work-like 	procedures,
interacting appropriately with the general public, getting along
with coworkers or peers without distracting them or exhibiting
behavioral extremes; and in responding appropriately to changes in
the work setting. He further opined that the claimant would be
absent from work 14 days per month and would be off task for 5
hours 	in 	an 	8-hour 	workday 	due 	to 	the 	symptoms 	of 	her
impairments. CNP Onyeukwu’s opinion that the claimant is unable
to sustain work and/or cannot work is on an issue reserved to the
Commissioner and therefore is inherently neither valuable nor
persuasive in accordance with 20 CFR 416.920b(c) and will not be
analyzed further. As to counselor Allen, the undersigned notes that
a licensed professional counselor is not an acceptable medical
source for purposes of our regulations (see 20 CFR 416.902(a)).
Nonetheless, the undersigned considered both providers’ treatment
of the claimant to inform the residual functional capacity finding.
To 	the 	extent 	that 	these 	opinions 	suggest 	that 	the 	claimant
experiences 	work-preclusive 	levels 	of 	off-task 	behavior 	and
absenteeism, they are neither supported with these providers’
examinations of the claimant, nor are they consistent with the other
evidence of record. Although these providers’ other findings as to
the 	claimant’s 	mental 	functional 	limitations 	are 	not 	entirely
unsupported by their own examinations of the claimant (e.g., as to
CNP Onyeukwu, 1F/23-26, 40-44; 7F/1; and as to counselor Allen,
see generally 1F and 7F), later examinations with the claimant
after the dates of these opinions showed improvement in the
claimant’s 	anxiety 	and 	in 	her 	social 	interactions, 	and 	her
examination findings were largely unremarkable (e.g., 1F/14-18;
7F/16-24). Moreover, the more complete medical record does not
support 	finding 	that 	the 	claimant 	has 	more 	than 	moderate
limitations in any area of mental functioning. As to the claimant’s
memory, the claimant’s examinations do not give any indication
that her memory is anything other than unremarkable (e.g., 1F/36-
38; 1F/32-33; 1F/26-28; 7F/16-24). While there is some indication
that the claimant had difficulty completing tasks such as self-
care/grooming (e.g., 3F/11 (01/17/23)), this improved significantly
with 	therapy 	(e.g., 	3F/20 	(03/08/23); 	6F/31 	(06/07/23)). 	The
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claimant also reported that she can care for her injured mother and
for pets (4E/3; 9E/2; Testimony). Her hobbies include reading,
writing, listening to music, and playing video games, all of which
require some measure of concentration (4E/6). She can follow
written 	and 	spoken 	instructions 	“decently 	well” 	(4E/7). 	Her
examinations generally show that her attention and concentration
were sustained (e.g., 1F/36-38 (06/17/22); 1F/32-33 (07/28/22);
1F/30-32 (08/04/22); 1F/22-23 (08/26/22); 7F/16-24 (11/23/22)).
As to the claimant’s social anxiety and difficulty interacting with
others, the claimant’s counseling and therapy records show that the
claimant reported being able to be more social; she went to a
friend’s house and celebrated a friend’s birthday even though she
had been anxious (3F/18 (02/22/23)); she attended Comicon with
friends despite anxiety (6F/41 (03/29/23)); she attended a family
celebration 	(6F/29 	(06/21/23)); 	she 	reported 	improvements 	in
seeking out social situations (6F/15 (08/02/23)); she reported
feeling that she had progressed since starting therapy because she
could make her own calls, spend time with friends, and meet new
people, even though she felt anxious (6F/11 (08/09/23)); she
reported attending a social event despite being anxious (6F/7
(08/30/23)); and she reported plans to attend a masquerade ball and
a family member’s wedding (6F/5 (09/06/23)). After reviewing the
evidence of record available to them, including some of the
aforementioned examination findings and reports, the state agency
psychological consultants opined that the claimant is capable of
concentrating, persisting, and maintaining pace to carry out a
simple learned routine in a structured and predictable work setting;
she 	has 	some 	limitations 	in 	interacting 	with 	supervisors,
coworkers, and the general public; and she is capable of adapting
to a setting in which duties are routine and predictable (2A/7-8;
4A/8-9). 	This 	evidence 	is 	not 	consistent 	with 	the 	CNP 	and
counselor’s opinions that the claimant is either unable to meet
competitive standards or is seriously limited in nearly all mental
functional areas. Accordingly, the undersigned finds these opinions
unpersuasive.
(ECF No. 7, PageID #: 66-67).
This discussion makes clear that the ALJ adequately addressed the supportability and
consistency of the opinions. 	As to supportability, the ALJ specifically noted that while Allen’s
and Onyeukwu’s treatment notes supported some mental limitations, they did not support the
work preclusive limitations opined because Plaintiff’s “examinations do not give any indication
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that her memory is anything other than unremarkable” and “generally show that her attention and
concentration were sustained.” 	(Id. at PageID #: 66-67; see id. at PageID #: 296-97, 301, 305,
307, 311). The ALJ also considered consistency with the overall medical record, indicating that
the record was not consistent with the preclusive limitations because there was improvement in
Plaintiff’s anxiety and social interactions over time and Plaintiff’s reported hobbies required at
least some level of concentration. 	(Id. at PageID #: 66-67; see id. at PageID #: 289, 291, 389,
426). The cited evidence is sufficient to support the ALJ’s conclusions regarding the opinions.
To the extent Plaintiff argues the ALJ failed to consider a single specific record
indicating that Plaintiff needs to “create routines,” or that Plaintiff was in weekly therapy, such
argument is unavailing. 	Rather, the record Plaintiff cites from a therapy session in September
2023 supports the ALJ’s overall conclusion that Plaintiff’s impairments improved with treatment
such that the work preclusive limitations were unnecessary. 	(See ECF No. 7, Page ID #: 398
(discussing Plaintiff’s attempt to create positive routines and how “she is feeling good” and “not
allowing her anxiety to control her”).
b. 	Koricke and Gonzalez
Plaintiff next challenges the ALJ’s consideration of a questionnaire completed by
Koricke and Gonzalez. 	(ECF No. 8 at 10). 	Plaintiff argues that in finding the opinion
unsupported because Plaintiff reported lessening anxiety, the ALJ failed to consider additional
records showing she continued to struggle with depression and anxiety. 	(Id. at 10-11). 	The
Commissioner argues the ALJ properly considered the opinion and Plaintiff’s reciting of “a few
subjective statements about her anxiety in an effort to show that the ALJ erred” does not change
that the ALJ’s decision is supported by substantial evidence. (ECF No. 9 at 14).
The ALJ discussed his consideration of the relevant questionnaire as follows:
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The undersigned finds unpersuasive the opinions of the claimant’s
clinical psychology providers, Elyra Gonzalez, Ph.D. intern, and
Deborah A. Koricke, Ph.D., dated July 1, 2023 (4F), opining that
the claimant has no useful ability to function in nearly all areas of
concentration and persistence and in all areas of adaptation; that
she is unable to meet competitive standards as to understanding
and memory and as to social interactions; that the claimant would
be 	absent 	from 	work 	every 	day 	due 	to 	her 	impairments 	or
treatment; and that the claimant would be off-task 100% of an 8-
hour 	work 	day 	(4F). 	The 	opinion 	is 	not 	supported 	by 	Ms.
Gonzalez’s own treatment records with the claimant. Throughout
the course of therapy with Ms. Gonzalez, the claimant reported
some anxiety (e.g., 3F/11, 17; 6F/5), some lack of motivation to
complete self-care (e.g., 3F/11), and stress surrounding family
events and schooling (e.g., 6F/9, 13, 17, 27). Otherwise, the
claimant reported lessening anxiety (e.g., 6F/31), improvement in
her sleep (e.g., 3F/10; 6F/31), improvements in her self-care and
hygiene (e.g., 3F/20; 6F/31), and overall improvement in her
thoughts or mood (e.g., 3F/20; 6F/1, 3, 5). Moreover, the claimant
reported being able to be social and interact with others despite
being anxious (e.g., 3F/18, 20; 6F/5, 7, 11, 15, 29, 41). The more
complete 	medical 	record 	supports 	that 	the 	combination 	of
medication, 	counseling, 	and 	therapy 	improved 	the 	claimant’s
symptoms such that she has no more than moderate limitations in
the areas of mental functioning. As to the claimant’s memory, the
claimant’s 	examinations 	do 	not 	give 	any 	indication 	that 	her
memory is anything other than unremarkable (e.g., 1F/36-38;
1F/32-33; 1F/26-28; 7F/16-24). While there is some indication that
the 	claimant 	had 	difficulty 	completing 	tasks 	such 	as 	self-
care/grooming (e.g., 3F/11 (01/17/23)), this improved significantly
with 	therapy 	(e.g., 	3F/20 	(03/08/23); 	6F/31 	(06/07/23)). 	The
claimant also reported that she is able to care for her injured
mother and for pets (4E/3; 9E/2; Testimony). Her hobbies include
reading, writing, listening to music, and playing video games, all
of which require some measure of concentration (4E/6). She is able
to follow written and spoken instructions “decently well” (4E/7).
Her examinations generally show that the claimant’s attention and
concentration were sustained (e.g., 1F/36-38 (06/17/22); 1F/32-33
(07/28/22); 1F/30-32 (08/04/22); 1F/22-23 (08/26/22); 7F/16-24
(11/23/22)). These findings are not consistent with the opinion that
the claimant has no useful ability to function or is unable to meet
competitive 	standards 	in 	these 	areas. 	Moreover, 	there 	is 	no
evidence 	in 	the 	record 	to 	support 	that 	the 	claimant 	would
experience 	work-preclusive 	levels 	of 	absenteeism 	or 	off-task
behavior. 	Because 	this 	opinion 	is 	neither 	supported 	by 	the
providers’ own examinations of the claimant nor is it consistent
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with the more complete medical record, the undersigned finds it
unpersuasive.
(ECF No. 7, PageID #: 65-66).
The ALJ adequately discussed the supportability and consistency factors in finding this
opinion unpersuasive. 	The ALJ noted that there was not support for the opinion in Gonzalez’s
treatment records because while Plaintiff reported anxiety, stress, and grooming struggles on
occasion, she overall reported lessening anxiety; improvement with her sleep, self-care, and
mood; and increased social interactions. 	(ECF No. 7, Page ID #: 379 (improvement in sleep);
396, 398, 400, 402 (improvement in grooming and overall feeling better); 406 (recognizing
improvement with therapy); 410, 436 (increased focus on social activities)). As with Allen’s and
Onyeukwu’s opinions, the ALJ found Koricke’s and Gonzalez’s opinion inconsistent with the
overall medical record, citing Plaintiff’s unremarkable memory on examination; improvement
with therapy; and Plaintiff’s reported hobbies. (Id. at PageID #: 65-66; see id. at PageID #: 289,
291, 389, 426). Substantial evidence supports the ALJ’s analysis of this opinion.
c. 	Cohen and Koricke
Within her challenge to Gonzalez’s and Koricke’s opinion, Plaintiff appears to assert a
conclusory challenge to the ALJ’s consideration of the opinion of Cohen and Koricke. (ECF No.
8 at 11-12). The entirety of Plaintiff’s argument as to the opinion reads:
The ALJ then found that earlier assessments from Dr. Koricke
were partially persuasive. This assessment, however, dealt with
testing which confirmed that Plaintiff had ADHD and borderline
intellectual functioning. Per the ALJ, “the more complete medical
record shows some degree of impairment in the claimant’s ability
to understand, remember, or apply information.” Although he cited
records in his analysis, the totality of the information failed to
provide support for his determination and was not consistent with
the 	medical 	information 	in 	the 	records. 	The 	ALJ’s 	finding,
therefore, was in error as it was not supported by substantial
evidence in the record. This error was harmful necessitating a
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remand of this matter.
(Id. (record citations omitted)).
The ALJ considered this opinion and explained his reasoning for finding it partially
persuasive:
The undersigned finds partially persuasive the opinions of Cynthia
Cohen, 	M.A., 	intern, 	and 	Deborah 	A. 	Koricke, 	Ph.D., 	dated
October 20, 2022, and April 10, 2023 (3F) opining that the
claimant’s assessment scores warranted a diagnosis of ADHD, and
further opining that the claimant would be likely to experience
memory 	deficits 	and 	slower 	cognitive 	speeds. 	Ms. 	Cohen’s
credentials are not evident in the record and it is unclear whether
she is an acceptable medical source under our regulations. Even if
she is not, Dr. Koricke’s signature on the opinion appears to
signify that Dr. Koricke adopted the opinion, and Dr. Koricke is an
acceptable medical source. That said, the undersigned finds this
opinion partially persuasive insofar as the claimant has been
diagnosed with ADHD, because the diagnosis is supported by the
assessments 	issued 	by 	Cohen 	and 	Koricke 	and 	is 	generally
consistent with the other evidence of record. However, the opinion
does not opine as to the mental functional limitations that the
claimant 	experiences 	in 	a 	work 	context; 	rather, 	the 	opinion
contains 	only 	the 	observation 	that 	the 	claimant 	is 	likely 	to
experience memory deficits and slower cognitive speeds. Although
the claimant’s assessment results with Cohen and Koricke show
some deficits in these areas, the claimant’s examination findings
consistently demonstrate that her memory was within normal
limits, and her fund of knowledge was okay (e.g., 1F/40-44
(06/10/22); 1F/38-40 (06/10/22);1F/36-38 (06/17/22); 1F/34-36
(06/24/22)); 1F/32-33 (07/28/22); 1F/30-32 (08/04/22); 1F/26-28
(08/18/22); 1F/22-23 (08/26/22); 7F/16-24 (11/23/22)). There are
some instances in which she reported issues of memory, but her
examination was unremarkable (e.g., 1F/28-30 (08/11/22)). At a
consultative physical examination, the claimant’s memory was
good 	(2F/5). 	The 	claimant’s 	therapy 	notes 	indicate 	that 	the
claimant needed encouragement and reminders to engage in good
grooming and hygiene (e.g., 3F/11 (01/17/23); 3F/20 (03/08/23);
6F/31 (06/07/23)). Thus, while the more complete medical record
shows some degree of impairment in the claimant’s ability to
understand, remember, or apply information, it does not show that
the claimant has experienced significant difficulty in these areas of
mental functioning as a result. Accordingly, the undersigned finds
this opinion partially persuasive.
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(ECF No. 7, PageID #: 64-65).
Based on Plaintiff’s argument, it is unclear what aspect of the ALJ’s consideration of the
opinion she challenges. Nor is it clear on review how the opinion’s conclusion that Plaintiff had
ADHD and would potentially suffer from memory deficits and slower cognitive speeds is
inconsistent with the ALJ’s adopted RFC, which limited Plaintiff to “a static work environment”
with “few changes in a routine work setting” with any changes in the job duties being explained;
simple, routine and repetitive tasks; and superficial interaction with the public. 	(ECF No. 7,
PageID #: 51). The ALJ’s discussion makes clear that while he found the opinion supported by
the test results included in the opinion, Cohen and Koricke did not opine as to specific
limitations in a work context. 	To the extent the opinion could be construed as finding Plaintiff
had limitations based on likely memory deficits and slower cognitive speeds, the ALJ found
limitations greater than those contained in the RFC were inconsistent with the record evidence
that Plaintiff’s memory was within normal limits and her fund of knowledge was okay. 	Thus,
the ALJ properly considered the opinion, and his analysis is supported by substantial evidence.
d. 	Caminero
Plaintiff next challenges the ALJ’s consideration of Caminero’s opinion, arguing the ALJ
“selectively chose which parts of the opinion to find persuasive” and this “piecemeal and
selective analysis of this opinion was in error as it was neither supported by nor consistent with
the medical records.” (ECF No. 8 at 12). The Commissioner responds that substantial evidence
supports the ALJ’s evaluation of the opinion and under Sixth Circuit case law, what Plaintiff
characterizes as “cherry-picking” is simply “weighing the evidence.” 	(ECF No. 9 at 15-16)
(citing Griffith v. Comm’r of Soc. Sec., No. 1:23-cv-618, 2023 WL 9271172, at *10 (N.D. Ohio
Dec. 11, 2023)).
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The ALJ discussed Caminero’s opinion as follows:
The undersigned finds partially persuasive the opinion of the
claimant’s provider Francheska Caminero, D.O., dated August 22,
2023 (5F). Dr. Caminero treats the claimant’s fibromyalgia and
opined that the claimant is capable of sitting for 120 minutes at one
time, standing for 15 minutes at one time, and sitting for at least 6
hours in an 8-hour workday; she would require unscheduled breaks
a few times each day; she can frequently lift less than 10 pounds,
occasionally lift 10 pounds, rarely lift 20 pounds, and never lift 50
pounds; she is limited to reaching handling, and fingering 50% of
the time; she is likely to be off-task for 20% of a work day; she is
capable of low stress work; and that she is likely to be absent four
days per month due to her impairments or treatment (5F/2-4). Dr.
Caminero’s opinion as to the claimant’s ability to stand and walk
total in an 8-hour workday is unclear because her check mark on
the form falls between the boxes for “less than 2 hours” and “about
2 hours” (5F/2). The undersigned finds Dr. Caminero’s opinion
partially 	persuasive 	insofar 	as 	Dr. 	Caminero 	has 	a 	treating
relationship 	with 	the 	claimant, 	and 	her 	opinions 	as 	to 	the
claimant’s sitting, limitations on lifting over 50 pounds, and
capability for low stress work are generally consistent with the
other evidence of record. However, there is no clear support for Dr.
Caminero’s opinion otherwise because the only treatment note
from Dr. Caminero in the record is from an appointment where the
claimant sought to have her claim paperwork filled out, and the
claimant’s examination was unremarkable (7F/2-10 (08/22/23)).
Dr. Caminero’s opinions as to more significant limitations on the
claimant’s standing, need for unscheduled breaks, lifting, reaching,
handling, fingering, her off-task behavior, and her absenteeism, are
not clearly supported, nor are they consistent with the more
complete 	medical 	record. 	Between 	September 	of 	2021 	and
December of 2022, there are no remarkable examination findings
or reports. Rather, at the claimant’s September 2021 physical, her
provider noted that she had not been seen in over a year, and her
examination was unremarkable (1F/50-51 (09/20/21)). At a follow-
up examination a few weeks later, the claimant reported worsening
fibromyalgia symptoms, and her provider discussed changing her
fibromyalgia medication depending upon interactions with the
claimant’s 	mental 	health 	medication 	(1F/48-49 	(10/07/21)).
Otherwise, there are no records of examinations related to the
claimant’s physical impairments until December of 2022. At the
claimant’s 	mental 	health 	examinations 	during 	that 	time, 	she
reported pain on only one occasion between September of 2021
and October of 2022 (1F/42 (06/10/22) (reporting back and joint
pain at 4/10 severity); see generally 1F). The results of the
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claimant’s consultative examination are not consistent with Dr.
Caminero’s opinions, either: the claimant’s gait was steady and
symmetric; her straight leg test was negative; her sensation and
reflexes 	were 	normal 	throughout; 	she 	had 	tenderness 	in 	her
cervical spine, thoracic spine, lateral shoulders, and (AC) joint
bilaterally; she was able to lift, carry, and handle light objects; her
fine and gross manipulation were grossly normal; she could squat
and rise with ease, could rise from sitting without assistance, and
got up and down from the exam table with ease; her heel-toe walk
and tandem walking were normal; she could stand and hop on one
foot bilaterally; she had good range of motion in all of her
extremities; 	she 	had 	some 	weakness 	in 	her 	bilateral 	upper
extremities, 	but 	her 	lower 	extremities 	had 	normal 	strength,
sensation, and motor function, and she had good balance (2F/5-6,
8-13). 	There 	are 	no 	examination 	findings 	that 	support 	the
significant degree of limitation that Dr. Caminero has opined as to
the claimant’s standing, need for unscheduled breaks, lifting,
reaching, 	handling, 	fingering, 	her 	off-task 	behavior, 	or 	her
absenteeism. But since Dr. Caminero’s opinion as to the claimant’s
sitting, lifting of heavier objects, and capability for low-stress work
are 	otherwise 	supported 	and 	consistent 	with 	the 	record, 	the
undersigned finds this opinion partially persuasive.
(ECF No. 7, PageID #: 63-64).
As noted by the ALJ in his discussion, the only treatment record from Caminero was on
August 22, 2023, when Plaintiff’s chief complaint was needing disability paperwork completed.
(Id. at PageID #: 443). 	At this visit, Plaintiff’s subjective complaints of back pain and painful
hand swelling were noted, but examination revealed Plaintiff had normal range of motion with
no other significant findings. (Id. at PageID #: 445-47). Thus, as the ALJ concluded, Caminero’s
opinion was not supported by her own treatment notes. 	Additionally, the ALJ concluded
Caminero’s 	opinions 	concerning 	standing, 	lifting, 	reaching, 	handling, 	fingering, 	off-task
behavior, absenteeism, and need for breaks were inconsistent with the record, which showed
minimal treatment related to Plaintiff’s pain and large gaps between visits. 	(Id. at PageID #:
324-25 (September 20, 2021 note that Plaintiff had not been seen in over one year and denied
pain or swelling)). 	Contrary to Plaintiff’s arguments, the ALJ adequately explained his
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22
consideration of the opinion and his reasoning for finding it only partially persuasive, with
appropriate explanation of the supportability and consistency of the opinion.
e. 	Oh
Plaintiff next challenges the ALJ’s consideration of Oh’s opinion, arguing that the ALJ
“adopted those parts of the record which supported his RFC and found that the portions of the
record addressing reaching, fingering, and feeling were not consistent with the record” but Oh
“supported his findings by noting that [Plaintiff] had point tenderness and weakness in her
bilateral upper extremities.” (ECF No. 8 at 11-12). The Commissioner responds that “the ALJ
directly addressed Dr. Oh’s opinion as to Plaintiff’s abilities with her arms and explained why
they were not supported by Dr. Oh’s examination findings and were inconsistent with other
evidence in the record.” (ECF No. 9 at 17).
The ALJ explained his consideration of Oh’s opinion:
The 	undersigned 	finds 	partially 	persuasive 	the 	opinion 	of
consultative examiner Paul Oh, M.D., dated December 17, 2022
(2F). Dr. Oh opined that the claimant has no limitations with
sitting, but mild limitations with standing, walking, and lifting; she
has no significant limitations with carrying weight or postural
activities; she is limited to frequent reaching, grasping, handling,
fingering, and feeling; and she had no other visual, communicative,
or workplace environmental limitations (2F/7). The undersigned
understands the reference to grasping to be part and parcel of
handling. The undersigned also acknowledges that the term “mild”
is vague. However, the undersigned finds Dr. Oh’s opinions as to
sitting, 	standing, 	walking, 	lifting, 	carrying 	weight, 	postural
activities, grasping, and handling to be supported and consistent
with the record. These opinions are consistent with a finding of
light exertion with some limitations on postural activities, and they
are supported by Dr. 	Oh’s examination of the claimant: the
claimant’s gait was steady and symmetric; her straight leg test was
negative; she could squat and rise with ease, could rise from sitting
without assistance, and got up and down from the exam table with
ease. Her heel-toe walk and tandem walking were normal. She
could stand and hop on one foot bilaterally. She had good range of
motion in all of her extremities. Her lower extremities had normal
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23
strength, sensation, and motor function, and she had good balance
(2F/5-6, 8-13). In contrast, the undersigned is not persuaded by Dr.
Oh’s opinions as to reaching, fingering, and feeling because they
are 	not 	supported 	by 	Dr. 	Oh’s 	examination 	findings. 	As 	to
reaching, Dr. Oh’s opinion does not specify limitations in any
particular plane, so it appears to limit the claimant’s reaching
across 	all 	planes 	and, 	as 	such, 	is 	overly 	restrictive. 	On
examination, the claimant had some weakness in her bilateral
upper extremities, but her sensation and reflexes were normal
throughout; she had tenderness in her spine and shoulders, but she
was able to lift, carry, and handle light objects; and her fine and
gross manipulation were grossly normal (2F/5). She also had good
range of motion in all of her extremities (2F/6, 8-13). These
findings do not support significant limitations on reaching across
planes other than overhead, nor do they support limitations on
fingering or feeling. These limitations are also not consistent with
the other evidence of record because the claimant’s examinations
generally do not show limitations in her sensation, reflexes, range
of motion, strength, or coordination that would support limiting her
reaching in other planes, fingering, or feeling (e.g., 1F/50-51
(09/20/21); 7F/6 (08/22/23)). This evidence suggests that the
portions of Dr. Oh’s opinion addressing reaching, fingering, and
feeling 	are 	not 	consistent 	with 	the 	record. 	Accordingly, 	the
undersigned finds this opinion partially persuasive.
(ECF No. 7, PageID #: 63).
With respect to his rejection of Oh’s opinions concerning Plaintiff’s reaching, fingering,
and feeling, the ALJ adequately explained why such were not supported by or consistent with the
record. 	He specifically noted that while Oh indicated Plaintiff had tenderness in her spine and
shoulders, she was still able to lift, carry, and handle light objects, had normal manipulation, and
good range of motions such that a finding restricting reaching in all planes rather than simply
overhead was not supported. (Id.; see id. at PageID #: 361-63). The ALJ further noted that the
limitations were not consistent with the overall record because other examinations did not show
limitations in sensation, reflexes, range of motion, strength, or coordination. 	(Id. at PageID #:
63; id. at 324-25 (examination noting normal extremities without discussion of limitations), 447
(noting normal general and cervical range of motion)). Thus, the ALJ did not err in considering
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this opinion.
f. 	State Agency
Finally, Plaintiff presents a conclusory challenge to the ALJ’s consideration of the State
agency opinions, arguing that “although the ALJ found that these reports were partially
persuasive, he failed to explain his rational for only adopting those elements which were
inconsistent [sic] with his desired RFC.” (ECF No. 8 at 14). The Commissioner argues Plaintiff
waived her argument because she “never identifies whether she is suggesting the ALJ erred in
evaluating the state agency findings as to her physical or mental limitations (or both)” and she
does not “explain what findings the ALJ failed to adopt or provide any specifics as to how the
ALJ’s evaluation of the state agency physical of [sic] mental findings were lacking.” (ECF No. 9
at 17-18).
The Commissioner’s argument is persuasive. Plaintiff fails to identify which portions of
the State agency opinions she contends the ALJ improperly rejected or adopted. (ECF No. 8 at
14). Thus, she has waived her argument. 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.”). To
the extent Plaintiff’s reference to the vocational expert’s testimony regarding handling, fingering,
and reaching 50% of the time can be construed as an argument the ALJ failed to properly
consider the State agency opinions on this issue, such argument is unavailing. The State agency
consultants opined that Plaintiff was “limited to frequent overhead and handling due to
fibromyalgia.” 	(ECF No. 7, Page ID #: 110, 122). 	The ALJ included this limitation in the
ultimate RFC. (Id. at PageID #: 51 (“she can frequently reach overhead and frequently handle)).
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Plaintiff fails to identify any evidence supporting greater limitations such that it is unclear how
she alleges the ALJ erred.
g. 	Summary
Overall, the ALJ considered the relevant medical opinions and explained his treatment of
each, specifically as to each opinion’s supportability and consistency with the medical records,
and his conclusions are supported by substantial evidence. While Plaintiff highlights records that
may have supported different ultimate conclusions as to the opinions, “a claimant does not
establish a lack of substantial evidence by pointing to evidence of record that supports her
position. Rather, [the claimant] must demonstrate that there is no sufficient evidence in the
record that would allow a reasoning mind to accept the ALJ’s conclusion.” Greene ex rel. Green
v. Astrue, No. 1:10-cv-0414, 2010 WL 5021033, at *4 (N.D. Ohio Dec. 3, 2010). 	At best,
Plaintiff’s arguments are a “veiled attempt to have [the Court] reweigh the evidence,” but such is
not an appropriate role for the Court. 	Nasser v. Comm’r of Soc. Sec., No. 22-1293, 2022 WL
17348838, at *2 (6th Cir. Dec. 1 , 2022); see Reynolds v. Comm’r of Soc. Sec., 424 F. App’x
411, 414 (6th Cir. 2011) (noting that the court “reviews the entire administrative record, but does
not reconsider facts, re-weigh the evidence, resolve conflicts in evidence, decide questions of
credibility, or substitute its judgment for that of the ALJ”). 	Accordingly, Plaintiff’s first issue
does not warrant remand.
3. 	Consideration of All Impairments
In her second issue, Plaintiff argues that the ALJ erred when he failed to consider all of
her impairments and limitations as required by SSR 96-8p. 	However, Plaintiff’s argument is
confusing and difficult to follow as she seems to take a “kitchen-sink” approach where she
vaguely cites multiple regulations and cases without setting forth a clear position as to how the
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ALJ erred. 	(See ECF No. 8 at 15-18). 	It appears Plaintiff is arguing that the ALJ failed to
properly consider the impact and limitations of her fibromyalgia based on her subjective
complaints regarding pain. (Id.).
The Commissioner responds that the ALJ properly evaluated Plaintiff’s subjective
symptom complaints and Plaintiff’s argument is “nothing more than a request for this Court to
try the case de novo.” 	(ECF No. 9 at 18). 	The Commissioner asserts that in evaluating
Plaintiff’s symptoms, the ALJ properly considered the duration, frequency, and intensity of her
symptoms along with the precipitating and aggravating factors; Plaintiff’s medication and other
treatments; and her activities of living as reflected in the record. (Id. at 19-20).
As Plaintiff argues, SSR 96-8p requires an ALJ to “consider limitations and restrictions
imposed by all of an individual’s impairments, even those that are not ‘severe.’” 	SSR 98-6p,
1996 WL 374184, at *5. 	Further, “[t]he RFC assessment must include a discussion of why
reported symptom-related functional limitations and restrictions can or cannot reasonably be
accepted as consistent with the medical and other evidence.” 	Id. at *7. 	When evaluating
subjective complaints, an ALJ must look to medical evidence, statements by the claimant, other
information provided by medical sources, and any other relevant evidence on the record. 	20
C.F.R. § 416.929(c); SSR 16-3p, 2017 WL 5180304. 	Beyond the medical evidence, an ALJ
should consider daily activities; location, duration, frequency, and intensity of the pain or other
symptoms; factors the precipitate and aggravate the symptoms; type, dosage, effectiveness, and
side effects of medication to alleviate pain or other symptoms; treatment other than medication;
any measures other than treatment the individual uses to relieve symptoms; and any other factors
concerning the individual’s functional limitations and restrictions. 	SSR 16-3p, 2017 WL
5180304, *7-8. The ALJ need not analyze all seven factors but should show that he considered
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the relevant evidence. See Cross v. Comm’r of Soc. Sec., 373 F. Supp. 2d 724, 733 (N.D. Ohio
2005). 	An ALJ’s “decision must contain specific reasons for the weight given to the
individual’s symptoms … and be clearly articulated so the individual and any subsequent
reviewer can assess how the adjudicator evaluated the individual’s symptoms.” 	Id.; see also
Felisky v. Bowen, 35 F.3d 1027, 1036 (6th Cir. 1994) (“If an ALJ rejects a claimant’s testimony
as incredible, he must clearly state his reason for doing so.”).
Here, the ALJ recognized Plaintiff’s complaints of pain she attributed to her fibromyalgia
and her testimony regarding the impact on her ability to complete various activities. (ECF No.
7, PageID #: 52). The ALJ explained his conclusion that Plaintiff’s physical symptoms were not
as severe as alleged:
The 	claimant’s 	allegations 	of 	disabling 	physical 	functional
limitations are not entirely consistent with the evidence of record.
As to the claimant’s allegations of daily pain in her hands, ankles,
and 	back, 	the 	record 	is 	not 	entirely 	consistent 	with 	those
allegations. 	The 	claimant 	generally 	reported 	difficulty 	with
fibromyalgia (e.g., 1F/48-49), and she reported some back pain at a
mental health appointment (1F/42 (06/10/22)). At her consultative
examination, she reported that her fibromyalgia mainly impacts her
bilateral shoulders and hands; but on examination, she had some
weakness in her upper extremities, but she was able to lift, carry,
and handle light objects; her straight leg test was negative; her fine
and gross manipulation were grossly normal; and her sensation,
reflexes, and range of motion was good in all her extremities
(2F/5-6, 	8-13). 	Similarly, 	when 	the 	claimant 	sought 	for 	her
provider to fill out her paperwork and she reported back and hand
pain, her examination was unremarkable (7F/2-10). The claimant
testified that she cares for her mother, who was injured; she helps
her wash her clothes and bathe her (Testimony). She also cares for
pets and is able to do laundry (4E/3-4; 9E/2). These activities as
described by the claimant involve the use of her hands, back, and
ankles for mobility. Also, the claimant generally did not report
such symptoms to medical providers consistently throughout the
treatment 	records, 	which 	is 	not 	entirely 	consistent 	with
experiencing these symptoms as she has reported. After reviewing
the medical evidence of record available to them, including some
of the aforementioned physical examination findings and reports,
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the state agency medical consultants opined that the claimant is
capable of light exertion with some additional limitations on the
use of her upper extremities, but no significant limitations on
postural activities (2A/4-7; 4A/5-7). Those findings are consistent
with the evidence of record, but not entirely consistent with the
claimant’s allegations of more significant limitations.
As to the claimant’s allegations of difficulty standing longer than
15-30 minutes, walking for longer than 15 minutes, and sitting for
longer 	periods 	(like driving), 	the allegations are not 	entirely
consistent 	with 	the 	evidence 	of 	record. 	At 	the 	claimant’s
consultative examination, her gait was steady and symmetric; her
sensation and reflexes were normal throughout; she could squat
and rise with ease, could rise from sitting without assistance, and
got up and down from the exam table with ease; her heel-toe walk
and tandem walking were normal; she could stand and hop on one
foot bilaterally; she had good range of motion in all of her
extremities; 	and 	her 	lower 	extremities 	had 	normal 	strength,
sensation, and motor function (2F/5-6, 8-13). Her other physical
examinations 	were 	unremarkable 	(e.g., 	7F/2-10). 	Even 	the
claimant’s treating physician opined that the claimant is capable of
sitting for 120 minutes at one time and sitting for at least 6 hours in
an 	8-hour 	workday 	(5F/2), 	which 	is 	inconsistent 	with 	the
claimant’s 	allegations 	of 	more 	significant 	limitations. 	After
reviewing 	the 	evidence 	of 	record, 	including 	some 	of 	the
aforementioned findings, the state agency medical consultants
opined, in part, that the claimant is capable of light exertion
without additional restrictions on standing, walking, or sitting
(2A/4-7; 	4A/5-7), 	which 	is 	consistent 	with 	the 	record. 	The
claimant’s 	allegations 	are 	not 	entirely 	consistent 	with 	these
persuasive 	portions 	of 	the 	state 	agency 	medical 	consultants’
opinions.
The undersigned is cognizant that the degree of limitation that a
person might experience from fibromyalgia and other impairments
might not necessarily be reflected in a particular treatment note;
however, in the instant matter, the longitudinal record does not
reflect a significant degree of physical functional limitation from
the claimant’s physical impairments. Her physical examinations do
not reflect the degree and frequency of pain one would expect
based on her testimony. The physical examinations findings also
do 	not 	support 	loss 	of strength, 	range of 	motion, 	sensation,
reflexes, or coordination that would support a disabling degree of
physical 	limitation. 	The 	medical 	evidence, 	even 	with 	a
consideration of limitations from pain, does not support a greater
degree of limitation than that which is set forth in the above
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residual functional capacity assessment.
In sum, the claimant’s alleged physical functional limitations are
not 	entirely 	consistent 	with 	the 	claimant’s 	reported 	daily
functioning, the examination findings of record, and the persuasive
portions of the medical opinions. Nonetheless, the above evidence
supports that the claimant has experienced the degree of limitation
reflected in the residual functional capacity assessment above.
(ECF No. 7, PageID #: 58-59).
This discussion makes clear that the ALJ found Plaintiff’s testimony regarding the
severity of her pain not credible based on proper factors, including the lack of corresponding
objective medical evidence; Plaintiff’s infrequent complaints of pain to her providers; and
Plaintiff’s self-reported activities. 	See SSR 16-3p, 2017 WL 5180304, *7-8. 	While Plaintiff
argues her testimony was corroborated by “medical evidence,” she largely cites to records
reflecting her own subjective complaints rather than objective medical findings. (ECF No. 8 at
16-17; see ECF No. 7, PageID #: 316 (noting Plaintiff’s reports of back and joint pain at a four
on a ten-point scale); 358 (noting Plaintiff’s reports of her symptoms in the “History of Present
Illness”); 419 (noting Plaintiff’s reports of back pain and bilateral hand swelling). 	The only
objective record Plaintiff cites is Oh’s observation that she had “some weakness in her bilateral
upper extremities,” but Plaintiff fails to acknowledge that the remainder of this opinion indicates
that she maintained “4/5 strength throughout all her shoulder and elbow exercises.” (ECF No. 7,
PageID #: 362).
Ultimately, while the ALJ recognized Plaintiff’s fibromyalgia diagnosis as a severe
impairment and considered her subjective complaints of pain, he properly found that additional
functional limitations were not supported by the overall record, including the objective medical
evidence and Plaintiff’s own reports of her daily activities. See Torres v. Comm’r of Soc. Sec.,
490 F. App’x 748, 754 (6th Cir. 2012) (ALJ did not err in considering the lack of objective
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evidence to support plaintiff’s pain complaints related to fibromyalgia because “a diagnosis of
fibromyalgia does not automatically entitle [a plaintiff] to disability benefits” and the overall
record did not support additional limitations). 	Substantial evidence supports this decision, and
because the Court does not reweigh the evidence when reviewing an ALJ’s decision, no
compelling reason exists for the Court to disturb the ALJ’s credibility finding. 	Cross, 373 F.
Supp. 2d at 732.
VI. Recommendation
Based on the foregoing, it is RECOMMENDED that the Court OVERRULE Marquez’s
Statement of Errors and AFFIRM the Commissioner’s decision.
Dated: October 29, 2025
_______________________________________________________
OBJECTIONS
Any objections to this Report and Recommendation must be filed with the Clerk of
Courts within fourteen (14) days after being served with a copy of this document. Failure to file
objections within the specified time may forfeit the right to appeal the District Court’s order. See
Berkshire v. Beauvais, 928 F. 3d 520, 530-31 (6th Cir. 2019).
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