Case Name in Social Security Case - Unavailable

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IN THE UNITED STATES DISTRICT COURT
FOR THE SOUTHERN DISTRICT OF OHIO
EASTERN DIVISION
Jacqueline B.,
Plaintiff, 	Case No. 2:25-cv-295
v. 	District Judge James L. Graham
Magistrate Judge Kimberly A. Jolson
Frank Bisignano, Commissioner
of Social Security,
Defendant.
Opinion and Order
Plaintiff Jacqueline B. filed an application for Disability Insurance Benefits on October 6,
2021, alleging disability beginning March 23, 2021 due to depression, anxiety, migraines, incisional
hernia, and polycystic ovarian syndrome. 	An Administrative Law Judge (ALJ) denied Plaintiff’s
application in a written decision. After the Appeals Council denied Plaintiff’s request for review, she
filed the instant suit.
Plaintiff’s Statement of Errors was referred to the Magistrate Judge pursuant to 28 U.S.C.
§636(b) for a Report and Recommendation, which was issued on November 25, 2025. The Magistrate
Judge recommended that the Commissioner of Social Security’s decision denying benefits be affirmed.
This matter is now before the Court on Plaintiff’s objection to the Report and Recommendation.
I.
The ALJ conducted a review of the evidence concerning Plaintiff’s physical and mental
impairments. The ALJ found that she has physical limitations, which are not at issue in the present
action. Regarding mental impairments, the ALJ reviewed the diagnosis and treatment of Plaintiff’s
mild major depressive disorder with anxiety. The ALJ found that conservative treatment in the form
of counseling and medications was effective. The ALJ summarized as follows:
Mentally, [Plaintiff] also showed improved moods and progress with conservative
treatment, including medication management and counseling. 	Her mental status
exams are consistent with anxiety and depression, but otherwise largely intact (see
Exhibits 2F, 8F, 9F, 10F, 14F). 	[Plaintiff]’s activities of daily living are somewhat
limited due to lack of motivation; however, she was able to do some household chores,
drive, prepare dinner, travel, and play video games (see e.g., Exhibits 9F, 14F/799,
745, 251, 283, 733, 810, 776, 270). She appears well groomed (Exhibit 2F, 9F).
(R. at 53).
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The ALJ determined that Plaintiff has the following impairments: obesity, diabetes, migraine
headaches, hypertension, incarcerated ventral hernia status-post repair, polycystic ovarian syndrome,
and major depressive disorder with anxious distress. The ALJ found, however, that none of Plaintiff’s
impairments, either singly or in combination, meets or medically equals a listed impairment. The ALJ
noted that conservative treatment had been effective in alleviating the physical and mental symptoms
of her impairments.
The ALJ assessed Plaintiff’s residual functional capacity (“RFC”) as follows:
[Plaintiff] has the residual functional capacity to perform light work as defined in 20
CFR 404.1567(b) except [Plaintiff] can never climb ladders, ropes, or scaffolds. She
can occasionally climb ramps and stairs. She can occasionally balance as that term is
defined in the Dictionary of Occupational Titles. She can occasionally stoop, kneel,
crouch and crawl. 	She would need to avoid exposure to all hazards, including
commercial driving, operating hazardous machinery, and unprotected heights. 	She
can understand, remember and carry out simple instructions. 	She cannot perform
work requiring a specific production rate such as assembly line work or work that
requires hourly quotas. 	She can tolerate occasional interaction with coworkers and
supervisors. She can have no interaction with the public. She can deal with occasional
changes in a routine work setting. She must avoid exposure to bright lights such as
direct sunlight.
(R. at 48–49).
Relying on a vocational expert’s testimony, the ALJ found that, considering Plaintiff’s age,
education, work experience, and RFC, there are jobs which exist in significant numbers in the national
economy that Plaintiff can perform at the light exertional level, such as a marker, router, garment sort,
or small parts assembler. (R. at 55–56). The ALJ thus concluded that Plaintiff “has not been under a
disability, as defined in the Social Security Act, from March 23, 2021, through the date of this decision
(20 CFR 404.1520(g)).” (R. at 56).
II.
In her Statement of Errors, Plaintiff asserted that the ALJ erred when evaluating the medical
source opinion of consultative psychologist, Jessica Twehues, Psy.D., as well as the opinions of two
state agency reviewing psychologists. As an initial matter, it should be noted that the Magistrate Judge
found no error in the ALJ’s evaluation of the opinions of the two state agency psychologists, and
Plaintiff has not objected to the Magistrate Judge’s determination in that regard.
With respect to Dr. Twehues, Plaintiff challenged the ALJ’s decision not to give full weight to
certain aspects of Dr. Twehues’s opinion. 	Specifically, the ALJ found the following aspects of her
opinion to be “not fully persuasive”: that Plaintiff was easily distracted, prone to high rates of
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absenteeism, and would have difficulty coping with workplace stress. 	(R. at 54). 	The ALJ did,
however, give some weight to Dr. Twehues’s opinion and “incorporated appropriate limitations into
the residual functional capacity.” (Id.).
The 	Magistrate 	Judge 	reviewed 	the 	ALJ’s 	treatment 	of 	Dr. 	Twehues’s 	opinion 	for
supportability and consistency. 	An ALJ is not required to “defer or give any specific evidentiary
weight, including controlling weight, to any medical opinion(s).” 20 C.F.R. § 404.1520c(a). Instead,
an ALJ must consider five factors: (1) supportability; (2) consistency; (3) the medical professional’s
relationship with Plaintiff; (4) specialization; and (5) other factors, such as “evidence showing a
medical source has familiarity with the other evidence in the claim or an understanding of [the SSA’s]
disability programs policies and evidentiary requirements.” § 404.1520c(c)(1)–(5). Supportability and
consistency are the most important of the five factors, and the ALJ must explain how they were
considered. See 20 C.F.R. § 404.1520c(b)(2).
The Magistrate Judge found that the ALJ properly analyzed both the supportability and
consistency of Dr. Twehues’s opinion. 	Briefly stated, the Magistrate Judge found that the ALJ
properly explained that the conclusions at issue were not supportable because they conflicted with the
results of Dr. Twehues’s own psychological and mental status examinations of Plaintiff. And as to
consistency, the Magistrate Judge determined that the ALJ had properly compared the conclusions at
issue to other record evidence and found them to be in conflict with Plaintiff’s counseling records and
primary care treatment records, as well as the conclusions of other medical opinions.
III.
The Court conducts a de novo review of the portion of the Report and Recommendation to
which Plaintiff objects. 	See 28 U.S.C. § 636(b)(1)(C). 	Plaintiff’s objection concerns only the
supportability factor. Supportability requires the ALJ to evaluate how much the medical conclusions
are supported internally, as well as by other treatment notes and exams by the evaluating physician.
See 20 C.F.R 404 § 1520c(c)(1).
Important to the Magistrate Judge’s analysis of the supportability factor was that the ALJ put
weight on the fact that Dr. Twehues herself had conducted a psychological assessment and a mental
status examination of Plaintiff. In the ALJ’s view, the conclusions which Dr. Twehues gave – that
Plaintiff was easily distracted, prone to high rates of absenteeism, and would have difficulty coping
with workplace stress – conflicted with the findings and results of Dr. Twehues’s psychological
assessment and mental health status examination. Those evaluations found “only mild to moderate
interpersonal 	conflict, 	moderate 	symptoms 	of 	depression 	and 	anxiety,” 	and 	no 	severe
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psychopathology. (R. at 54). Dr. Twehues observed that Plaintiff was “pleasant and cooperative,”
was able to follow instructions and engage in conversation, and had “normal intellectual abilities.” (R.
at 47, 51). 	The ALJ found that Dr. Twehues, in arriving at the conclusion that Plaintiff could not
function in a workplace environment (because of distraction, likely high absenteeism, and stress) had
relied too heavily on Plaintiff’s subjective, self-reported limitations and had done so contrary to the
results of the psychological and mental health assessments. In light of the ALJ’s review of the evidence
and express discussion of why the conclusions at issue were not fully persuasive, the Magistrate Judge
found that the ALJ had properly evaluated the supportability of Dr. Twehues’s opinion.
In her objection, Plaintiff takes aim at the following passage of the Magistrate Judge’s Report
and Recommendation:
[T]he ALJ found that in coming to her conclusions, Dr. Twehues “did not offer a
specific function-by-function assessment of what the claimant could do despite her
impairments.” (R. at 54 (citing R. at 657)). In similar circumstances, this Court has
found such an analysis [by the ALJ] to satisfy the supportability component. Cf. Misty
K. v. Comm’r of Soc. Sec., No. 2:21-CV-548, 2022 WL 4376229, at *6 (S.D. Ohio Sept.
22, 2022) (“As for supportability, the ALJ is correct in describing Dr. Cooperrider’s
opinion as vague. Dr. Cooperrider merely asserts that that Plaintiff is legally blind and
unable to perform most work activities”); see also Tonya J. v. Comm’r of Soc. Sec., No. 1:21-
CV-00757, 2022 WL 4621621, at *4 (S.D. Ohio Sept. 30, 2022) (holding the ALJ
conducted a supportability analysis where the medical opinion didn’t include specific
functional limitations and the ALJ found the opinion was, thus, “vague as to the actual
levels of functional ability or limitations.”).
Doc. 10 at PAGEID 1804.
Plaintiff argues that the Magistrate Judge erred because the cited cases relate to a vagueness
problem, while the ALJ here did not find Dr. Twehues’s opinions to be vague. Upon review of the
ALJ’s decision, the Court agrees that the ALJ did not use the term “vague” to describe Dr. Twehues’s
opinion. Even so, the Court finds the cases cited by the Magistrate Judge to be instructive because
the underlying concern in those cases was that the medical opinions lacked internal support – their
conclusions were not anchored in specific medical facts or findings. 	So too here, Dr. Twehues’s
conclusion as to the severe limitations on Plaintiff’s ability to cope with a workplace environment is,
without more, overbroad and not supported by the particularized findings she made in her
psychological assessment and mental status examination. 	In the absence of a function-by-function
assessment by Dr. Twehues, it was reasonable for the ALJ to find that Dr. Twehues’s conclusions
could not be logically traced back to the results of the assessment and examination. 	As the ALJ
observed, the only consideration which could explain how Dr. Twehues arrived at her expansive view
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of Plaintiff’s limitations was Plaintiff’s self-reporting. 	The ALJ permissibly found Dr. Twehues’s
reliance on self-reporting to be “less persuasive” in light of the record evidence, including the
psychological assessment and mental status examination conducted by Dr. Twehues. (R. at 54). See
Michael R. v. Comm’r of Soc. Sec., No. 2:22-CV-4117, 2023 WL 6160626, at *6 (S.D. Ohio Sept. 21, 2023)
(holding that the ALJ permissibly discounted a medical opinion which was based on the claimant’s
self-reports and was contradicted by the medical professional’s own treatment records of the
claimant)..
Finally, Plaintiff contends that the Magistrate Judge improperly created a post hoc rationalization
to bolster the ALJ’s decision. She argues that “the ALJ’s evaluation of Dr. Twehues’ opinions does
not suggest that her opinions were based on [Plaintiff’s] subjective complaints.” Doc. 11 at PAGEID
1817. The Court disagrees. Though the ALJ’s analysis did not use the term “subjective complaints,”
it plainly discussed Dr. Twehues’s reliance on Plaintiff’s “self-reported” complaints. (R. at 54). As
the ALJ directly explained, “Dr. Twehues did not offer a specific function-by-function assessment of
what the claimant could do despite her impairments,” but instead she “reiterated” Plaintiff’s “self-
reported symptoms and limitations.” (Id.).
The Court thus finds that the ALJ sufficiently analyzed the supportability of Dr. Twehues’s
opinion.
IV.
On de novo review, the Court finds that the ALJ’s decision is supported by substantial evidence.
See Blakley v. Comm’r of Soc. Sec., 581 F.3d 399, 406 (6th Cir. 2009); 42 U.S.C. § 405(g). Accordingly,
Plaintiff’s objection (Doc. 11) to the Report and Recommendation is OVERRULED. 	The Report
and Recommendation (Doc. 10) is hereby adopted in its entirety and the Court AFFIRMS the
Commissioner’s decision.
s/ James L. Graham
JAMES L. GRAHAM
United States District Judge
DATE: February 9, 2026
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