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UNITED STATES DISTRICT COURT
MIDDLE DISTRICT OF PENNSYLVANIA

NICOLE L. POFF, : No. 3:25-CV-308
Plaintiff, : (Brann, C.J.)
Vv. : (Caraballo, M.2J.)
FRANK BISIGNANO,!
Commissioner of Social
Security,
Defendant

REPORT AND RECOMMENDATION

I. Introduction

Plaintiff Nicole L. Poff seeks judicial review of the final decision of
the Commissioner of Social Security (the “Commissioner”) denying her
application for disability insurance benefits and supplemental security
income under Titles IIT and XVI of the Social Security Act. The Court
has jurisdiction pursuant to 42 U.S.C. § 405(g).

This matter was referred to the undersigned to prepare a report

and recommendation addressing the merits of two alleged errors that

1Frank Bisignano was confirmed as the Commissioner of the Social Security
Administration on May 6, 2025. Pursuant to Rule 25(d) of the Federal Rules of Civil
Procedure and 42 U.S.C. § 405(g), Frank Bisignano is substituted as the defendant
in this suit.

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the Administrative Law Judge (“ALJ”) committed when determining
that Poff was not disabled under the Social Security Act. Namely, Poff
claims that the ALJ erred when he evaluated: (1) the medical opinions
of treating source Jennifer Clark, C.R.N.P., and consultative examiner
Karena Hammon, N.P; and (2) Poff’s subjective symptom complaints.
Doc. 13 at 2-15. The matter is fully briefed and ripe for decision.

As explained below, the ALJ’s conclusions when addressing both
challenged issues were supported by substantial evidence in the record,
coupled with sufficient reasoning to permit meaningful judicial review.
Accordingly, the undersigned respectfully recommends that the Court
affirm the Commissioner’s decision to deny Poff’s claim for social
security disability benefits and supplemental security income.

II. Background

On January 10, 2023, Poff applied for both social security
disability insurance benefits and supplemental security income. Doc. 8
at 215-53 (hereinafter referred to as “Tr.”). Poff alleged complete
disability in these applications from a myriad of impairments, including
herniated discs, degenerative disc disease, scoliosis, bilateral knee

surgeries, psoriatic arthritis, fibromyalgia, rheumatoid arthritis,

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bilateral carpal tunnel syndrome, left arm tendinitis, and bilateral
plantar fasciitis. Id. at 82. Poff's applications were initially denied in
October 2028. Id. at 93, 107. After her claims were denied on
reconsideration in March 2024, Poff requested a hearing before an ALJ.
Id. at 156.

On September 13, 2024, ALJ Howard Kauffman presided over
Poff's hearing. The hearing concerned whether Poff was disabled within
the meaning of the Social Security Act since December 5, 2022. Tr. 17.
At the hearing, ALJ Kauffman received various evidence of record,
including clinical records, medical history, medical expert reports,
vocational expert testimony, and Poff’s own testimony. Jd. at 32-81.

On September 19, 2024, ALJ Kauffman issued a decision
concluding that Poff was not disabled between the operative dates of
December 5, 2022, through the date of the decision. Jd. at 14-17, 31.
ALJ Kauffman reached that conclusion by employing a five-step
analytical process required under the Social Security Act to evaluate

disability insurance and supplemental security income claims. See 20

C.F.R. § 404.1520(a)(4).

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The process requires sequential consideration of: (1) whether the
claimant is engaged in substantial gainful work activity; (2) the medical
severity of the claimant’s impairments; (8) whether the impairment
meets or equals a defined list of impairments; (4) a comparison between
the claimant’s past relevant work and residual functional capacity, 1.e.,
the most work that a claimant can perform despite his or her
limitations, see 20 C.F.R. § 404.1545(a); and (5) an assessment of the
claimant’s residual functional capacity and his or her age, education,
and work experience. 20 C.F.R. § 404.1520(a)(4)G)-(v). Should a
claimant proceed past the first three steps of the analysis, the
Commissioner will not find the claimant disabled when he or she can
perform past relevant work, or adjust to other work, under the third
and fourth steps, respectively. Id. at § 404.1520(a)(4)av)-(v), (f), (g).

Applying that analysis, ALJ Kauffman first determined that Poff
met the insurance requirements of the Social Security Act, see 20 C.F.R.
§ 404.130, through December 31, 2026. Tr. 19. ALJ Kauffman also
found that Poff had not engaged in substantial gainful activity between
her alleged disability onset date of December 5, 2022, through the date

of the decision. Id.

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At the second step of the analysis, ALJ Kauffman found that Poff
suffered from eight severe impairments: degenerative joint disease of
the right knee, degenerative disc disease of the lumbar spine, migraine
headaches, obesity, psoriatic arthritis, fibromyalgia, and tachycardia.
Id. at 20. ALJ Kauffman also identified several non-severe
impairments, including mild obstructive sleep apnea, gastroesophageal
reflux disease, hyperlipidemia, hypertension, restless leg syndrome,
carpal tunnel syndrome, depression, anxiety, and intermittent explosive
disorder. Id. at 20-22. He found that the evidence showed such
conditions had significantly improved and caused “no more than ‘mild’
limitation in any of the functional areas... .” Jd. at 20-21.

Moving to the third step of the analysis, ALJ Kauffman
determined that Poffs eight severe impairments failed to meet or
medically equal one of the impairments listed in the Social Security
Administration’s regulations. Id. at 22. Poff thus did not automatically
qualify as disabled. See 20 C.F-.R. § 404.1520(a)(4)@ii) (“Tf you have an
impairment(s) that meets or equals one of our listings in appendix 1 of

this subpart and meets the duration requirement, we will find that you

are disabled.”).

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Accordingly, ALJ Kauffman proceeded to determine Poff’s residual

functional capacity, before addressing the final two steps in the

sequential analysis. Based on the evidence of record, ALJ Kauffman

concluded that Poff could perform sedentary work:

After careful consideration of the entire record, the
undersigned finds that the claimant has the residual
functional capacity to perform sedentary work as defined in
20 CFR 404.1567(a) and 416.967(a) except she can
occasionally climb ramps and stairs and occasionally balance,
stoop, kneel, crouch, and crawl, she cannot climb ladders,
ropes, or scaffolds, no concentrated exposure to extreme cold,
extreme heat, vibration, fumes, dusts, gases, odors, poor
ventilation, unprotected heights, and moving machine parts.

Tr. 22-23.

In reaching that conclusion, ALJ Kauffman considered three

pieces of evidence germane to this opinion. First, he considered Poff’s

testimony regarding her impairment symptoms:

The claimant alleges disability due to chronic pain with
psoriasis arthritis as well as osteoarthritis, fibromyalgia, and
migraine headaches. The claimant testified that she
underwent two knee surgeries previously and that she is
unable to squat, bend, or kneel and has difficulty with stairs.
She testified that her knee gives out and that she has pain
and swelling in her joints, worse with cold, rain, and snow.
She testified to widespread pain and fatigue due to
fibromyalgia. She testified that she uses a cane at times but
that it was not prescribed. She testified to migraine
headaches and that she feels lightheaded and dizzy at times.
She testified to weight loss with her weight down to 270

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pounds from 390 pounds and that 60 pounds was “water”

weight (Hearing Testimony). The claimant alleges difficulty

lifting, standing, reaching, walking, sitting, using her hands,

and concentrating (Exhibit 9E).
Id. at 23.

In reviewing that testimony, in comparison to the record,
ALJ Kauffman concluded “that the claimant’s medically
determinable impairments could reasonably be expected to cause
the alleged symptoms.” Id. The ALJ found, however, that Poff’s
“statements concerning the intensity, persistence and limiting
effects of these symptoms are not entirely consistent with the
medical evidence and other evidence in the record... .” Jd. In
particular, ALJ Kauffman ultimately concluded that “[w]hile the
combination of the claimant’s severe impairments limits her to
work within the sedentary exertional level with additional non-
exertional limitations, the medical evidence of record,” including
various treatment notes, Poff's own testimonial statements, and
examination findings, collectively failed to “support a finding of

disability in this case.” Jd. at 29 (citing Exhibits 3F, 4F, 5F, 11F,

14F, 21F, 22F, 23F, and Hearing Testimony).

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Second, ALJ Kauffman evaluated the persuasiveness of the
medical opinion of consultative examiner Karena Hammon, N.P., in
determining the limitations imposed by Poff’s physical impairments. He
specifically considered Nurse Hammon’s assessment that Poff:

[Clan lift ten, twenty, and up to fifty pounds occasionally. She
can carry ten and twenty pounds occasionally. She can sit for
three hours at one time for a total of six hours in an eight-
hour workday. She can stand for 30 minutes at one time for a
total of two hours in an eight-hour workday. She can walk for
15 minutes at one time for a total of two hours in an eight-
hour workday. She does not require the use of a cane to
ambulate. She can reach, including overhead, handle, finger,
feel, push and pull frequently with either hand. She can
operate bilateral foot controls occasionally. She can never
balance, kneel, or crouch. She can occasionally climb stairs
and ramps, ladders or scaffolds, stoop, and crawl. She can
never tolerate exposure to unprotected heights, moving
mechanical parts, humidity, wetness, dust, odors, fumes,
pulmonary irritants, extreme cold, and extreme heat. She can
tolerate occasional exposure to operating a motor vehicle and
vibrations. She can tolerate a moderate noise work
environment. She is unable to walk a block at a reasonable
pace or climb a few steps at a reasonable pace with the use of
a single hand rail (Exhibit 8F).

Id. at 26.

Although the ALJ considered Nurse Hammon’s assessment of
Poffs functional abilities, he afforded it only partial persuasive value,
finding some of its limitations inconsistent with and unsupported by

other evidence of record, including the clinical records, treatment notes,

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and examination findings. Jd. (citing Exhibits 4F, 5F, 10F, 11F, 14F,
21F, 22F, 23F, and 26F).

Third, ALJ Kauffman evaluated the persuasiveness of the medical
opinion of treating source Jennifer M. Clark, C.R.N.P., in determining
the limitations imposed by Poffs physical and mental impairments. He
specifically considered Nurse Clark’s assessment that Poff’s symptoms:

[Wlould frequently interfere with attention and
concentration. She is unable to work in a competitive
environment, even a sedentary occupation, on a full time
basis. She can walk one block without rest. She can walk for
20-30 minutes at a time, stand for 20-20 minutes at a time,
and sit for 20-30 minutes at a time before needing to change
position. She can sit, stand, and/or walk for a total of four
hours in an eight-hour workday. She would need unscheduled
breaks for 15-30 minutes for 75 minutes. The claimant has
good days and bad days and would likely be absent from work
about three times a month. She must use a cane or other
assistive device while engaging in occasional
standing/walking. She has significant limitations in
performing repetitive reaching, handling, or fingering. She
can lift and carry five pounds frequently and ten pounds
occasionally. She can never carry more than ten pounds
(Exhibit 15F). On June 3, 2024, Nurse Clark again assessed
the claimant’s functional abilities: her symptoms would often
interfere with her attention and concentration. She would
need to elevate her legs four times during a normal workday.
She can sit for 30 minutes at one time for a total of four hours
in an eight-hour workday. She can stand or walk for 30
minutes at one time for a total of four hours each in an eight-
hour workday. She would need unscheduled 15-30 minute
breaks for 75 minutes during the workday. She can lift and
carry less than ten pounds frequently and ten pounds

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occasionally. She can frequently balance. She can never stoop,
kneel, and crouch. She can use her hands, fingers, and arms
each for 50% of the workday. She would be absent from work
more than four times a month (Exhibit 24F).

On January 9, 2024, Nurse Clark assessed the claimant’s
mental functional abilities: she has a marked (serious
limitation in the area and cannot generally be performed
satisfactorily) limitation in her ability to maintain attention
and concentration for extended periods of time. She has a
moderate (intermittent difficulty performing in the area and
cannot “always” be performed satisfactorily) limitation in her
ability to understand and remember short and simple
instructions, perform activities on schedule and maintain
regular attendance, complete a normal workweek and
workday without interruptions, and perform at a consistent
pace with a standard number and length of breaks. She has a
minimal (mild limitation but can generally function
satisfactorily) limitation in her ability to understand and
remember detailed instructions, perform simple and detailed
instructions, sustain an ordinary routine without special
supervision, and make simple work-related decisions. She has
no limitation in terms of social interaction. She would be
expected to be off-task 15-20% of the workday due to
psychologically based symptoms (Exhibit 15F). On June 3,
2024, Nurse Clark again assessed the claimant's mental
functional abilities. She found that the claimant’s abilities
and limitations remained unchanged compared to her prior
January 2024 opinion, as noted above (Exhibit 25F).

Tr. 28.

After considering Nurse Clark’s assessment of Poff’s functional

abilities, ALJ Kauffman did not afford it persuasive value, finding its

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limitations inconsistent with and unsupported by other evidence of
record, including Nurse Clark’s own examination notes, other medical
treatment notes, and other examination findings, he. Id. at 28-29
(citing Exhibits 4F, 5F, 10F, 11F, 12F, 14F, 21F, 22F, 23F, and 26F).

Based on these three findings, among others, ALJ Kauffman
deemed Poff capable of performing sedentary work subject to
limitations. This brought him to the fourth step of the analysis, to
determine whether Poff was disabled within the meaning of the Social
Security Act. Here, with assistance from a vocational expert’s
testimony, ALJ Kauffman compared Poff’s past relevant work and
residual functional capacity, finding that Poff was unable to perform
her prior employment as an inventory clerk. Jd. at 29.

Finally, in the fifth step of the sequential analysis process, ALJ
Kauffman considered Poffs age, education, work experience, and
residual functional capacity to perform sedentary work, concluding that
“there are jobs that exist in significant numbers in the national
economy that the claimant can perform|[.]” Jd. at 30. Here, ALJ
Kauffman again leveraged testimony from a vocational expert, who

advised that an individual fitting Poffs parameters could perform the

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occupational requirements of a ticket checker, appointment clerk, or
table worker. Tr. 30.

As a result of this analysis, ALJ Kauffman determined that Poff
was not disabled and denied her application for disability benefits. Id.
at 28. Poff unsuccessfully appealed the decision to the Social Security
Administration’s Appeals Council, which denied Poff’s request to review
ALJ Kauffman’s decision on December 26, 2024. Id. at 1. Having
exhausted her administrative remedies, Poff’s instant appeal to the
district court followed.

Poff initiated this action with the Court on February 20, 2025.
Doc. 1. The Commissioner filed an answer and provided the requisite
transcripts from the disability proceedings on May 28, 2025. Docs. 7, 8.
The parties then filed their respective briefs, Docs. 13, 15-16, with Poff
alleging two errors warranting reversal or remand, Doc. 18 at 2-15.

Specifically, Poff avers that ALJ Kauffman: (1) erred when
evaluating the medical opinions authored by Nurses Clark and
Hammon, contending that his articulation of the supportability and
consistency of these opinions was insufficient to permit meaningful

judicial review; and that he (2) did not have substantial evidence to

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support his finding that Poff’s subjective symptom testimony was not
supported by the record. Id.
Ill. Discussion

A. Standard of Review

Review of the Commissioner’s decision denying a claimant’s
application for social security disability benefits is limited to
determining whether the factual findings of the final decisionmaker are
supported by substantial evidence in the record. See 42 U.S.C. § 405(g);
Johnson v. Comm’ of Soc. Sec., 529 F.3d 198, 200 (8d Cir. 2008).
Substantial in this context is “more than a mere scintilla of evidence
but may be less than a preponderance.” Brown v. Bowen, 845 F.2d 1211,
1213 (8d Cir. 1988). Put more pointedly, it is “such relevant evidence as
a reasonable mind might accept as adequate to support a conclusion.”
Pierce v. Underwood, 487 U.S. 552, 565 (1988) (quoting Consol. Edison
Co. v. N.L.R.B., 305 U.S. 197, 229 (1988)) (citations omitted).

In an adequately developed record, this can mean “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.” Consolo v. Fed.

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Maritime Comm 'n., 383 U.S. 607, 620 (1966). Under this highly
deferential standard, “[f]actual findings which are supported by
substantial evidence must be upheld.” Ficca v. Astrue, 901 F. Supp. 2d
533, 5386 (M.D. Pa. 2012) (emphasis added); 42 U.S.C. § 405(g).

Thus, the Court’s role under this standard is not to re-weigh the
evidence and make factual determinations, but to simply review the
record to ensure factual findings are supported by substantial evidence,
and to confirm that the ALJ provided a “discussion of the evidence and
explanation of reasoning for his conclusion sufficient to enable judicial
review.” Diaz v. Comm’ of Soc. Sec., 577 F.3d 500, 504 (38d Cir. 2009)
(citations omitted). And although an ALJ’s decision must “reasonably
articulat[e]” its reasoning so “a subsequent reviewer or a reviewing
court” can trace its path, 82 Fed. Reg. 5844-01, 5858 (2017), an ALJ
need only give “some indication” of their consideration of probative
evidence to successfully carry this burden of articulation. Burnett v.
Comm’ of Soc. Sec. Admin., 220 F.3d 112, 121 (8d Cir. 2000).

In practical terms, this means that when there is countervailing,

probative evidence, an ALJ must “give some reason for discounting the

evidence she rejects.” Plummer v. Apfel, 186 F.3d 422, 429 (8d Cir.

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1999); cf. Mason v. Shalala, 994 F.2d 1058, 1064 (8d Cir. 1998) (holding
that the substantial evidence standard is unmet when an ALJ fails to
resolve a conflict created by countervailing evidence.). In the context of
evaluating the persuasiveness of medical opinions, which are often
some of the most probative evidence available, an ALJ is required to
assess the level of support and consistency the opinion has against the
record. 20 C.F.R. § 404.1520c.

Here, ALJ Kauffman’s factual findings were supported by
substantial evidence in the record, and the reasoning underlying those
conclusions was sufficiently articulated to permit judicial review.

B. The ALJ’s Evaluation of the Medical Opinions of
Nurse Clark and Nurse Hammon

Poff contends that ALJ Kauffman erred in his evaluation of the
favorable medical opinions of Karena Hammon, N.P., a consulting
examiner, and Jennifer Clark, a treating C.R.N.P. Poff argues that the
ALJ did not provide a sufficient explanation concerning the
supportability and consistency of these opinions in finding that they
were partly persuasive and unpersuasive, respectively. Doc. 13 at 2-15.

As set forth below, the ALJ’s evaluation of the persuasive value of these

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two opinions sufficiently assessed their supportability and consistency,
and his findings regarding each are supported by substantial evidence.

When evaluating a medical opinion, an ALJ is required to assess
the level of support and consistency the opinion has against the record.
20 C.F.R. § 404.1520c. The supportability of a medical opinion
“increases as the relevance of the objective medical evidence and
explanations presented by the medical source increases.” Vellone v.
Saul, 2021 WL 319354, at *6 (S.D.N.Y. 2021), report and
recommendation adopted, 2021 WL 2801138 (8.D.N.Y. 2021) (citing 20
C.F.R. § 404.1520c(c)(1)). The consistency assessment is “an all-
encompassing inquiry focused on how well a medical source is
supported, or not supported, by the entire record.” Clay v. Kijakazt,
2022 WL 13989015, at *3 (N.D. Miss. 2022) (quoting 20 C.F-.R.

§ 404.1520c(c)(1)).

Because an ALJ’s duty of articulation requires just “some
indication” of their consideration of probative evidence, Burnett, 220
F.3d at 121, an ALJ’s assessment of a medical opinion’s consistency and
supportability “need not discuss every piece of evidence in the record,”

and instead simply requires the building of “ ‘an accurate and logical

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bridge between the evidence and the result.’” Gamret v. Colvin, 994 F.
Supp. 2d 695, 698 (W.D. Pa. 2014) (quoting Hodes v. Apfel, 61
F.Supp.2d 798, 806 (N.D. Il. 1999); and Sarchet v. Chater, 78 F.3d 305,
307 (7th Cir. 1996)). Further, in assessing whether an ALJ has provided
an adequate analysis for rejecting or accepting an opinion, the court
must look to the opinion as a whole, not only the part directly
addressing the particular opinion. See Jones v. Barnhart, 364 F.3d 501,
505 (8d Cir. 2004) (“[T]he ALJ’s decision, read as a whole, illustrates
that the ALJ considered the appropriate factors in reaching the
conclusion that [claimant] did not meet the requirements for any
listing[.]”).

The sufficiency of an evaluation turns on the extent to which its
reasoning is driven by an ALJ’s read of the evidence—and the court’s
ability to discern that evidentiary reasoning. See, e.g., Price v. Astrue,
A401 F. App’x 985, 986 (Sth Cir. 2010) (‘The ALJ does not need to
comment on every piece of evidence, but only must build an accurate
and logical bridge between the evidence and the final determination.”)
(citing Glomski v. Massanari, 172 F. Supp. 2d 1079, 1082, (E.D. Wis.

2001)); Acosta Cuevas v. Comm’ of Soc. Sec., 2021 WL 363682, at *15

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(S.D.N.Y. 2021), report and recommendation adopted sub nom., 2022
WL 717612 (S.D.N.Y. 2022) (“[t]he ALJ must provide a reviewing Court
with a sufficient explanation to ensure that they have complied with the
legal procedures controlling their decision and cannot ignore or
mischaracterize evidence.”).
1. Nurse Hammon’s Opinion

Nurse Hammon performed a consultative examination of Poff on
September 9, 2023. Tr. 782. As explained by the ALJ, Nurse Hammon
found, in relevant part, that Poff could:

[Lift ten, twenty, and up to fifty pounds occasionally. She can
carry ten and twenty pounds occasionally. She can sit for
three hours at one time for a total of six hours in an eight-
hour workday. She can stand for 30 minutes at one time for a
total of two hours in an eight-hour workday. She can walk for
15 minutes at one time for a total of two hours in an eight-
hour workday. She does not require the use of a cane to
ambulate. She can reach, including overhead, handle, finger,
feel, push and pull frequently with either hand. She can
operate bilateral foot controls occasionally. She can never
balance, kneel, or crouch. She can occasionally climb stairs
and ramps, ladders or scaffolds, stoop, and crawl. She can
never tolerate exposure to unprotected heights, moving
mechanical parts, humidity, wetness, dust, odors, fumes,
pulmonary irritants, extreme cold, and extreme heat. She can
tolerate occasional exposure to operating a motor vehicle and
vibrations. She can tolerate a moderate noise work
environment. She is unable to walk a block at a reasonable
pace or climb a few steps at a reasonable pace with the use of
a single hand rail.

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Id. at 26, 788-938.

In evaluating Hammon’s findings, ALJ Kauffman concluded that
they were “partially persuasive,” specifically crediting those portions
regarding Poff’s “ability to sit, stand, and walk and that she does not
require the use of an assistive device to ambulate,” because ALJ
Kauffman himself found these “supported by the claimant’s
presentation that day.” Id. at 26. However, the ALJ concluded that
Hammon’s conclusions regarding Poff’s ability to lift weight, “use her
hands, operate foot controls, or tolerate only a moderate noise
environment,” unpersuasive, because they were not supported by her
“presentation that day or by her clinical history,” and inconsistent with
her “other physical examination findings and overall symptomatic
improvement with treatment in terms of her psoriasis, lower extremity
edema, knee pain, migraine headaches, and weight loss.” Id. This
evaluation of Hammon’s opinion, challenged by Poff now on appeal,
sufficiently discussed the evidence and was reasonably articulated to
permit meaningful judicial review.

The ALJ set forth his evidence-based reasoning for deeming

unpersuasive those portions of Hammon’s opinion concerning Poff’s

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ability to lift weight, use her hands, operate foot controls, and tolerate a
moderate noise environment. Specifically, ALJ Kauffman explained
that Poffs examination and clinical history did not support Nurse
Hammon’s opinions on those factors, which he also found inconsistent
“with the claimant’s other physical examination findings and overall
symptomatic improvement with treatment in terms of her psoriasis,
lower extremity edema, knee pain, migraine headaches, and weight
loss.” Tr. 26.

In support of that conclusion, ALJ Kauffman cited a series of
exhibits, without precise details concerning their relevance; an
approach that Poff deems “cursory” and an inarticulate “string citation.”
Doc. 13 at 5-6. Although those characterizations bear an element of
truth, and the ALJ’s analytical approach does not engender effective
judicial review, it does not thwart meaningful judicial review. “A
written evaluation of every piece of evidence is not required, as long as
the ALJ articulates at some minimum level her analysis of a particular
line of evidence. Moreover, the ALJ’s mere failure to cite specific

evidence does not establish that the ALJ failed to consider it.” Phillips

v. Barnhart, 91 F. App’x 775, 780 n.7 (8d Cir. 2004) Gnternal citation

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omitted). And a review of the cited evidence of record supports the
ALJ’s conclusions on the consistency and supportability of Nurse
Hammon’s opinions.

In Nurse Hammon’s relevant physical examination findings, she
found that Poff had 4/5 bilateral grip strength, that she could
manipulate a coin, pen, and cup without difficulty, that she had no
evident muscle atrophy, and that her joints were stable and non-

deformed. Tr. at 784—86. The treatment evidence identified by the ALJ

likewise showed that, most recently, Poff’s psoriasis had largely cleared

up with treatment (id. at 1036), that she no longer had edema (id. at
981), that her right knee had returned to its baseline prior to a previous
injury and that knee injections were providing additional relief as
needed (id. at 929, 935), that her migraines were well under control and
that she reportedly did not have very many (id. at 828, 967), and that
she had lost 85 pounds by watching her diet and staying active (id. at
981).

Moreover, although ALJ Kauffman did not address these medical

findings in the section of his opinion deeming a portion of Nurse

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Hammon’s opinion unpersuasive, he did review them elsewhere in the

opinion. Namely, the ALJ stated:

[Poff] presented [at her examination with Nurse Hammon]
with normal reflexes, no sensory deficit, 4/5 strength in her
upper and lower extremities, no evident muscle atrophy, no
cyanosis, clubbing, or edema in her extremities, 4/5 grip
strength bilaterally, and intact ability to manipulate a coin,
pen, and cup without difficulty[.] ....On April 29, 2024,
Nurse Clark advised that the claimant's migraines ‘are
currently under control[.]... [Seth Fuhrman, PA-C] noted
[on February 22, 2024, that] the claimant[ ] reported a return
to baseline after her December 2023 fall and injury to her
right knee..... Dr. Mastoor noted [on May 29, 2024,] that the
claimant has no edema and has had further weight loss, down
to 292 pounds. The claimant reported making diet changes
(stopped drinking soda) and that she was trying to stay active.
Dr. Mastoor found that the claimant presented with no edema
and no rash.”).

Tr. 25-26. The accuracy of this summary of the most recent medical

evidence is corroborated by the ALJ’s corresponding exhibit citations.

See id. at 828, 929, 935, 967, 981, 1036.

As Nurse Hammon’s examination findings show that Poff retained

erip strength and fine-motor control in her hands, and the most recent

treatment evidence shows that Poff had marked improvement in areas

effecting her ability to lift weight, use her feet, and tolerate

environmental stimuli, ALJ Kauffman’s determination that Nurse

Hammon’s findings on lifting, manipulation, and noise tolerance were

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unpersuasive was anchored in the record. By citing that record evidence
accordingly, the ALJ sufficiently built a bridge between the evidence
and his result. Gamret, 994 F. Supp. 2d at 698; Jones, 364 F.3d at 505.
And as the Court is obliged to review the totality of the decision when
assessing the adequacy of an AlJ’s analysis, Jones, 364 F.3d at 505,
ALJ Kauffman’s articulation of the medical evidence throughout the
opinion does not warrant remand simply because that analysis was not
reiterated in the specific section of the opinion deeming Nurse
Hammon’s findings partially persuasive.

Poffs contention that alternative evidence in the record supports
and is consistent with Nurse Hammon’s opinion, and thus undermines
ALJ Kauffman’s conclusion, is unavailing. In particular, Poff cites to
findings from Nurse Hammon’s evaluation of Poff that she contends
support all of Nurse Hammon’s limitation findings, including, among
other things, that Poff had “plaque like rashes” over her body,
tenderness in her knee joints and feet, and reduced 4/5 bilateral grip
strength. Doc. 18 at 6-7. Poff also cites to findings from other medical
evidence to support her contention that Nurse Hammon’s opinion

limitations are consistent with the record, including evidence showing

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that at various points in time Poff had rashes, tachycardia, back pain,
leg pain, morbid obesity, and degenerative knee problems. Id. at 7—8.
However, “[a] written evaluation of every piece of evidence is not
required,” Phillips, 91 F. App’x at 780 n.7, “and the possibility of
drawing two inconsistent conclusions from the evidence does not
prevent [the ALJ’s decision] from being supported by substantial
evidence.” Consolo, 383 U.S. at 620.

In essence, Poff asks the Court to reweigh the evidence in her
favor here, but “[clourts are not permitted to re-weigh the evidence or
impose their own factual determinations.” Chandler v. Comm’ of Soc.
Sec., 667 F.3d 356, 359 (8d Cir. 2011). Because ALJ Kauffman assessed
the weight of the evidence and cited to “such relevant evidence as a
reasonable mind might accept as adequate to support” his conclusion
concerning Nurse Hammon’s opinion, Pierce, 487 U.S. at 565, Poffs
disagreement with that determination does not warrant remand.
Rather, the ALJ’s evaluation is supported by substantial evidence in the
record and is sufficiently articulated to permit judicial review,

mandating affirmance. Gamret, 994 F. Supp. 2d at 698; Ficca, 901 F.

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Supp. 2d at 5386 (“Factual findings which are supported by substantial
evidence must be upheld.”).

Finally, although Poff contends otherwise, the ALJ incorporated
Nurse Hammon’s sitting, standing, and walking limitations into Poffs
residual functional capacity. As the government correctly notes, see Doc.
15 at 7, ALJ Kauffman determined that Poff had the residual functional
capacity to perform sedentary work, which limits an individual to
walking and standing for no more than “2 hours of an 8-hour workday,”
and sitting for “6 hours of an 8-hour workday.” Social Security Ruling
§3-10, 19838 WL 31251, at *5 (1983). Nurse Hammon found,
consistently, that Poff was limited to sitting for six hours and standing
and walking for two hours in total during an eight-hour workday. Tr.
789. Additionally, Nurse Hammon’s findings that Poff can only sit for
three hours at a time, stand for 30 minutes at a time, and walk for 15
minutes at a time, id., though not explicitly enumerated in Poff’s
residual functional capacity, fall within the limitations restricting her
to two hours of standing and walking, and six hours of sitting per

workday. Thus, Nurse Hammon’s findings regarding Poff’s sitting,

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standing, and walking limitations are reflected in Poff’s residual
functional capacity.
2. Nurse Clark’s Opinion

ALJ Kauffman’s opinion included an evaluation of four
assessments that Nurse Clark completed concerning Poff's mental and
physical functional abilities. ALJ Kauffman deemed all four
assessment, which found marked limitations, unpersuasive. Tr. at 28—
29. Two of Nurse Clark’s assessments, conducted on January 9, 2024,
and June 38, 2024, focused on Poff’s physical functional abilities and
found, as summarized by ALJ Kauffman, that her symptoms would:

[F]requently interfere with attention and concentration. She
is unable to work in a competitive environment, even a
sedentary occupation, on a full time basis. She can walk one
block without rest. She can walk for 20-30 minutes at a time,
stand for 20-[8]0 minutes at a time, and sit for 20-30 minutes
at a time before needing to change position. She can sit, stand,
and/or walk for a total of four hours in an eight-hour workday.
She would need unscheduled breaks for 15-30 minutes for 75
minutes. The claimant has good days and bad days and would
likely be absent from work about three times a month. She
must use a cane or other assistive device while engaging in
occasional standing/walking. She has significant limitations
in performing repetitive reaching, handling, or fingering. She
can lift and carry five pounds frequently and ten pounds
occasionally. She can never carry more than ten pounds. On
June 3, 2024, Nurse Clark again assessed the claimant’s
functional abilities: her symptoms would often interfere with
her attention and concentration. She would need to elevate

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her legs four times during a normal workday. She can sit for
30 minutes at one time for a total of four hours in an eight-
hour workday. She can stand or walk for 30 minutes at one
time for a total of four hours each in an eight-hour workday.
She would need unscheduled 15-380 minute breaks for 75
minutes during the workday. She can lift and carry less than
ten pounds frequently and ten pounds occasionally. She can
frequently balance. She can never stoop, kneel, and crouch.
She can use her hands, fingers, and arms each for 50% of the
workday. She would be absent from work more than four
times a month|.]

Tr. 29, 885-86.

ALJ Koffman deemed those determinations unpersuasive on
supportability and consistency grounds. First, the ALJ found that they
were “not supported by Nurse Clark’s own physical examinations of the
claimant,” which showed stable, normal findings. Id. at 28-29. ALJ
Kauffman cited several exhibits in the record as a basis for his
conclusion. Jd. A review of those exhibits reveals that from 2021 to
2024, Nurse Clark consistently found that Poff had a normal range of
motion, normal breath, normal heart measures, normal skin, normal
neurological findings, and a normal appearance. Jd. at 565-66, 575,
583-84, 617, 625, 633-34, 656, 706-07, 724, 737-38, 750-51, 760-61,

829-30, 838-39, 868, 873, 878, 960, 969—70, 978.

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That evidence, however, contrasts with Nurse Clark’s
determination that Poff suffered from significant limitations. Indeed,
Nurse Clark found that Poff could reach, handle, or finger with her
hands no more than 50% of the time, that she required a cane to walk,
that she could not sit for more than 20-30 minutes at a time, and that
she required unscheduled breaks every 75 minutes. Jd. at 883-86,
1021-22. Taken together, these severe restrictions might preclude Poff
from performing even sedentary work. See Social Security Ruling 88-10,
1983 WL 31251, at *5 (1988) “Most unskilled sedentary jobs require
good use of the hands and fingers for repetitive hand-finger actions.”).

ALJ Kauffman, however, identified the significant contrast
between Nurse Clark’s normal examination findings and severe
assessment determination as the basis for his conclusion that the
former failed to support the latter. Tr. 28 (“These findings are not
supported by Nurse Clark’s own physical examinations of the claimant,
showing overall stable, normal findings[.|”). As the ALJ cited the
aforementioned record evidence, which supports his determination of
discrepancies between Nurse Clark’s physical examination findings and

her conclusions, his opinion contains a logical and accurate bridge

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between the evidence and his conclusion. Gamret, 994 F. Supp. 2d at
698. Accordingly, ALJ Kauffman met his burden of articulation
concerning the supportability factor.

Second, the ALJ found that Nurse Clark’s physical assessments of
Poff were “not consistent with medical evidence of record,” which
showed improvement in Poff's symptoms with treatment, “including
improvement in her psoriasis, lower extremity edema, knee pain,
migraine headaches, and weight loss.” Tr. 28-29. Again, the ALJ cited
several exhibits in the record as a basis for his conclusion, the contents
of which support his determination. Jd. Namely, the cited medical
evidence shows that Poff’s psoriasis cleared up with treatment (id. at
1036), Poff no longer had edema (id. at 981), Poffs right knee had
returned to its baseline prior to a previous injury and that knee
injections were providing additional relief as needed (id. at 929, 935),
Poff's migraines were well under control, and she reportedly did not
have very many (id. at 828, 967), and Poff had lost 85 pounds by
watching her diet and staying active (id. at 981).

Thus, the ALJ concluded that Poff's improvement and near

cessation in certain symptoms contrasted with Nurse Clark’s work

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preclusive physical assessment findings. Specifically, Nurse Clark
found that Poff had severely limited abilities in the areas of reaching,
handling, fingering, walking, sitting, and staying on task, id. at 883-86,
1021-22; findings that might prove work preclusive. See Social Security
Ruling 88-10, 1983 WL at *5.

Again, ALJ Kauffman identified this discrepancy between Poff’s
positive treatment evidence and Nurse Clark’s assessment findings as
the basis for his finding of inconsistency. Id. at 28 (“They are also not
consistent with medical evidence of record, showing improvement in her
symptoms with treatment, including improvement in her psoriasis,
lower extremity edema, knee pain, migraine headaches, and weight
loss.”). As his comparison between the treatment evidence and
assessment findings was accurate and logically bridged any gap
between the evidence and the result, ALJ Kauffman met his burden of
articulation. Gamret, 994 F. Supp. 2d at 698; Jones, 364 F.3d at 505.

Poff cites other medical evidence supporting her contention that
Nurse Clark’s physical limitation findings were consistent with the
record, including records showing that at various times Poff had rashes,

tachycardia, back pain, leg pain, morbid obesity, and degenerative knee

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problems. Jd. at 11. But “[a] written evaluation of every piece of
evidence is not required,” Phillips, 91 F. App’x at 780 n.7, “and the
possibility of drawing two inconsistent conclusions from the evidence
does not prevent [the ALJ’s decision] from being supported by
substantial evidence.” Consolo, 383 U.S. at 620. Thus, because ALJ
Kauffman assessed the weight of the evidence and cited to “such
relevant evidence as a reasonable mind might accept as adequate to
support[]” his conclusion concerning the inconsistency of Nurse Clark’s
physical assessments, Poff’s disagreement with that determination does
not warrant remand. Pierce, 487 U.S. at 565.

Nurse Clark’s remaining two assessments of Poff, also conducted
on January 9, 2024, and June 8, 2024, focused on her mental functional
abilities and found, as summarized by ALJ Kauffman, that her
symptoms caused:

[M]arked (serious limitation in the area and cannot generally

be performed satisfactorily) limitation in her ability to

maintain attention and concentration for extended periods of

time. She has a moderate (intermittent difficulty performing

in the area and cannot “always” be performed satisfactorily)

limitation in her ability to understand and remember short

and simple instructions, perform activities on schedule and
maintain regular attendance, complete a normal workweek

and workday without interruptions, and perform at a
consistent pace with a standard number and length of breaks.

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She has a minimal (mild limitation but can generally function
satisfactorily) limitation in her ability to understand and
remember detailed instructions, perform simple and detailed
instructions, sustain an ordinary routine without special
supervision, and make simple work-related decisions. She has
no limitation in terms of social interaction. She would be
expected to be off-task 15-20% of the workday due to
psychologically based symptoms. On June 38, 2024, Nurse
Clark again assessed the claimant's mental functional
abilities. She found that the claimant’s abilities and
limitations remained unchanged compared to her prior
January 2024 opinion, as noted above|.|

Id. at 28, 887-88.

ALJ Koffman again deemed those determinations unpersuasive on
supportability and consistency grounds. First, the ALJ found that they
were “not supported by Nurse Clark’s treatment notes,” which “showed
overall stable, normal findings[.]” Tr. 28-29. A review of the exhibits
ALJ Kauffman cited in reaching that conclusion identifies supporting
evidence. Namely, findings from Nurse Clark’s mental examinations
demonstrate that from 2021 to 2024, she consistently found that Poff
had a normal mood, normal behavior, normal thought content, and
normal judgment. Id. at 565-66, 634, 738, 751, 829-30, 868, 873, 878,
970.

By contrast, Nurse Clark concluded that Poff had marked deficits

in the areas of sustaining concentration and attention. Id. at 28. Nurse

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Clark found that Poff had serious limitations in her ability to
concentrate and maintain attention for extended periods, and that these

limitations, coupled with additional limitations in the areas of

understanding and memory, would cause her to be off task 15-20% of

the time and render it moderately difficult for her to finish workdays
and workweeks without interruption. Tr. 887-88, 1024—25. The
disruptive effect these limitations would have on Poff’s ability to meet
the demands of a consistent, full time work schedule would potentially
preclude her employment in even sedentary positions. See Social
Security Ruling 96-9p, 1996 WL 3741885, at *9 (1996) (“A substantial
loss of ability to meet any one of several basic work-related activities on
a sustained basis (i.e., 8 hours a day, 5 days a week, or an equivalent
work schedule), will substantially erode the unskilled sedentary
occupational base and would justify a finding of disability.”).

ALJ Kauffman, however, contrasted the severity of Nurse Clark’s
assessment with her examination findings as his basis for finding the
former unsupported by the latter. Tr. 28-29 (“These findings are not
supported by Nurse Clark’s treatment notes, showing overall stable,

normal findings[.]”). As this comparison between the treatment

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evidence and assessment findings is supported in the record and
logically bridges any gap from the evidence to the result, ALJ Kauffman
met his burden of articulation. Gamret, 994 F. Supp. 2d at 698; Jones,
364 F.3d at 505.

Second, the ALJ found that Nurse Clark’s mental assessments of
Poff were “not consistent” with examination evidence that “noted
improvement in her symptoms with starting Zoloft and... normal
mental status... findings... .” Tr. 29. Again, a review of the exhibits
ALJ Kauffman cited in reaching that conclusion identifies supporting
evidence. Namely, examinations of Poff from 2023 and 2024 by Nurse
Clark and consultative examiner Kathleen Lederman revealed that Poff
had a regular affect and mood, fully intact attention, fully intact
concentration, fully intact memory, average intellectual functioning,
good insight, and good judgment, in addition to having controlled
symptoms of anxiety and depression once re-prescribed Zoloft. Id. at
851-52, 867-68, 872-78, 876-77, 968.

By contrast, Nurse Clark found that Poff had serious limitations
in her ability to concentrate and maintain attention for extended

periods. Id. at 887-88, 1024-25. When coupled with Nurse Clark’s other

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findings that Poff would have moderate difficulty meeting the demands
of a consistent, full time work schedule, Poff might be precluded from
employment in even sedentary positions. See Social Security Ruling 96-
9p, 1996 WL at *9 (“A substantial loss of ability to meet any one of
several basic work-related activities on a sustained basis (i.e:, 8 hours a
day, 5 days a week, or an equivalent work schedule), will substantially
erode the unskilled sedentary occupational base and would justify a
finding of disability.”).

ALJ Kauffman, however, contrasted the severity of Nurse Clark’s
evaluation with the examination findings by both Nurse Clark and
Kathleen Lederman as his basis for finding the former inconsistent with
the latter. Tr. 28-29 (“They are also not consistent with the claimant’s
noted improvement in her symptoms with starting Zoloft and her
normal mental status examination findings per her consultative
evaluation, as noted above [.]”). As this comparison between the
examination evidence and assessment findings is supported in the
record and logically bridges any gap from the evidence to the result,
ALJ Kauffman again met his burden of articulation. Gamret, 994 F.

Supp. 2d at 698; Jones, 364 F.3d at 505.

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Although Poff contends that ALJ Kauffman failed to consider
record evidence that allegedly supports and is consistent with Nurse
Clark’s mental assessments, a review of the ALJ’s opinion concludes
otherwise. In particular, Poff contends that ALJ Kauffman failed to
consider evidence of Poff's chronic pain, heavy medication regimen, side
effects from the medication regimen, indication that Poff’s “conditions
improved in the context of her stopping work[,|” and fibromyalgia. Doc.
13 at 10-11. As set forth above, however, the ALJ did specifically
discuss most of this evidence in his opinion, albeit in sections distinct

from his evaluation of Nurse Clark’s persuasiveness. For example, the

ALJ noted:

On April 6, 2028, Nurse Clark performed the claimant’s
annual physical examination. She noted that the claimant
reported getting relief [from her pain] with medical
marijuana. The claimant also complained of memory issues
and headaches with stopping oxycontin. The claimant
reported having migraines more often but did not want to
increase her amitriptyline dose. ... On October 16, 2028,
Nurse Clark examined the claimant. She noted the claimant
reported not having ‘very many migraines at all, maybe little
headaches.’ The claimant reported that her migraines were
due to stress from her last relationship and difficulty sleeping.
The claimant reported ongoing pain but did not want to make
any medication changes but had increased her medical
marijuana.

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Tr. 23-25. As the Court considers the ALJ’s opinion as a whole, Jones,
364 F.3d at 505, the location in which ALJ Kauffman addressed
treatment evidence does not detract from his conclusion.

Moreover, “[a] written evaluation of every piece of evidence is not
required, as long as the ALJ articulates at some minimum level her
analysis of a particular line of evidence.” Phillips, 91 F. App’x at 780 n.7
Ganternal citation omitted). Here, ALJ Kauffman sufficiently articulated
his analysis of the evidence concerning Nurse Clark’s examinations of
Poff. See Tr. 23-25. Requiring him to address every factor that Poff now
advances in her favor goes beyond the applicable standard. Moreover,
the evidence that Poff protests went unmentioned—two discrete
findings by Nurse Clark indicating that work cessation may have
contributed to improvement in two of Poff’s conditions—does not create
erounds for remand, as “the ALJ’s mere failure to cite specific evidence
does not establish that the ALJ failed to consider it.” Phillips, 91 F.
App’x 780 n.7.

Accordingly, ALJ Kauffman reasonably articulated his
determination that Nurse Clark’s opinions were unpersuasive, on both

supportability and consistency grounds. That conclusion, supported by

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substantial cited evidence, permits meaningful judicial review and
should be affirmed.

C. The ALJ’s Evaluation of Poff's Subjective Symptom
Complaints

Poff contends that ALJ Kauffman erred in his evaluation of her
subjective symptom complaints, by focusing too heavily on their
improvement with treatment. Doc. 13 at 14. As set forth below, the
ALJ’s evaluation of the consistency of Poffs alleged symptoms against
the objective evidence complied with his regulatory duty and was
supported by substantial evidence.

“Allegations of pain and other subjective symptoms must be
supported by objective medical evidence.” Hartranft v. Apfel, 181 F.3d
358, 362 (3d Cir. 1999) (citing 20 C.F.R. § 404.1529). Thus, when a
claimant’s statements about the severity of her impairment are not
well-grounded in the objective medical evidence, but the underlying
impairment “could reasonably be expected to produce” the complained
of pain or symptoms, the “ALJ must make a finding on the credibility of
the individual’s statements based on a consideration of the entire case

record.” McKean v. Colvin, 150 F. Supp. 3d 406, 415-16 (M.D. Pa. 2015).

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To this end, ALJs are required to consider all alleged symptoms
and the extent to which such symptoms are reasonably consistent with
the objective medical and other evidence. 20 C.F.R. §§ 404.1529(a),
416.929(a). The regulations require objective medical evidence from an
acceptable medical source showing the presence of an impairment that
could reasonably be expected to produce the symptoms alleged and that,
when considered with all the other evidence, would lead to a disability
determination. Id. When evaluating a claimant’s symptoms, the ALJ
must follow a two-step process to (1) ascertain whether the claimant
has a medically determinable impairment that could reasonably be
expected to produce the claimant’s alleged symptoms, and (2) evaluate
the intensity and persistence of the claimant’s symptoms such as pain
and determine the extent to which they limit the ability to perform
work-related activities. Social Security Ruling 16-8p, 2017 WL 518304,
at *3—4 (2017).

ALJ Kauffman properly followed this two-step process and
sufficiently compared Poff’s alleged symptoms to the objective medical
evidence. First, he concluded that Poff’s “medically determinable

impairments could reasonably be expected to cause” her alleged

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symptoms. Tr. 23. In reaching this determination, ALJ Kauffman found
that the record, including treatment records and examinations,
established Poff's degenerative joint disease of the right knee,
degenerative disc disease of the lumbar spine, migraine headaches,
obesity, psoriatic arthritis, fibromyalgia, and tachycardia. Tr. 20, 23-26.
The nature of these severe impairments, coupled with Poff's symptom
testimony about feeling lightheaded and dizzy at times, and having
impediments in her ability to squat, bend, kneel, climb stairs, lift,
stand, reach, walk, sit, use her hands, concentrate, and handle changes
in weather, led ALJ Kauffman to find that the latter could reasonably
cause the former. Id. at 23.

At the second step of the process, however, ALJ Kauffman
concluded that Poff’s “statements concerning the intensity, persistence
and limiting effects of these symptoms are not entirely consistent with
the medical evidence and other evidence in the record... .” Id. at 28.
The ALJ found that the evidence showed Poff’s symptoms significantly
improved or disappeared completely with treatment. Id. at 29.

In support of that determination, ALJ Kauffman highlighted

recent examination evidence showing that: Poff’s palpitations and lower

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extremity edema improved with medication; Poff denied chest pains or
palpations during a May 2024 medical exam, and was noted to have lost
a significant amount of weight through watching her diet and activity;
she no longer had edema or a rash; she testified at the hearing with the
ALJ that she recently lost more weight; she had not sought any
orthopedic treatment for her lower back, and her other alleged sources
of chronic pain, including fibromyalgia, were managed through primary
care treatment; her migraines were reportedly well under control; and
symptoms related to her right knee injury saw recent improvement
with injections. Jd. at 29. ALJ Kauffman specifically and accurately
cited to the medical records corroborating those factors, including
multiple cardiology visits (id. at 471, 981, 985), hearing testimony (id.
at 66), emergency department records (id. at 460-65), primary care
appointment records from 2021 to 2024 (id. at 553-765, 827-46, 866—
81, 955-80), and orthopedic treatment records (id. at 929).

Based on that substantial body of evidence, the ALJ deemed Poff’s
more severe symptom allegations inconsistent with the record, and thus
non-credible. Jd. That analysis of the evidence met ALJ Kauffiman’s

regulatory duty to evaluate the intensity and persistence of Poff’s

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symptoms against the evidence to determine the extent to which they
actually limited her work-related abilities. See 20 C.F.R. §§ 404.1529(a),
416.929(a); Phillips, 91 F. App’x at 780 (“[A] claimant must show that
_the impairment resulted in disabling limitations.”).

In opposition to the ALJ’s credibility determination, Poff contends
that the “mere improvement of symptoms alone does not disprove...
subjective allegations of disabling symptoms.” Doc. 18 at 15. This
contention, however, misapprehends the burden of persuasion
concerning subjective symptom allegations. A claimant’s statements
regarding subjective symptoms are not, by default, considered credible;
rather, “[alllegations of pain and other subjective symptoms must be
supported by objective medical evidence.” Hartranft, 181 F.3d at 362
(citing 20 C.F.R. § 404.1529).

Here, the ALJ assessed that objective medical evidence and
deemed it inconsistent with Poff’s symptom allegations, because the
evidence showed that the severity of Poff's symptoms had significantly
abated with recent treatments. See Tr. 29. Thus, pursuant to his
weighing of the evidence, ALJ Kauffman concluded that Poff’s

subjective symptom allegations were not credible; a determination

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entitled to significant deference. See Diaz, 577 F.3d at 506 (In
determining whether there is substantial evidence to support an
administrative law judge’s decision, we owe deference to his evaluation
of the evidence [and] assessment of the credibility of witnesses ... .”).
Accordingly, ALJ Kauffman complied with his regulatory duty in
evaluating Poffs symptom allegations, and his conclusion that her
allegations were not credible was supported by substantial evidence.
IV. Recommendation

For the forgoing reasons, IT IS RECOMMENDED that the
district court AFFIRM the Commissioner’s decision, direct that
judgment be entered in favor of the defendant, and instruct the clerk to
close this case. The parties are further placed on notice that pursuant to
Local Rule 72.3:

Any party may object to a magistrate judge’s proposed
findings, recommendations or report addressing a motion or
matter described in 28 U.S.C. § 636 (b)(1)(B) or making a
recommendation for the disposition of a prisoner case or a
habeas corpus petition within fourteen (14) days after being
served with a copy thereof. Such party shall file with the clerk
of court, and serve on the magistrate judge and all parties,
written objections which shall specifically identify the
portions of the proposed findings, recommendations or report
to which objection is made and the basis for such objections.
The briefing requirements set forth in Local Rule 72.2 shall
apply. A judge shall make a de novo determination of those

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portions of the report or specified proposed findings or
recommendations to which objection is made and may accept,
reject, or modify, in whole or in part, the findings or

recommendations made by the magistrate judge. The judge,
however, need conduct a new hearing only in his or her
discretion or where required by law, and may consider the
record developed before the magistrate judge, making his or
her own determination on the basis of that record. The judge
may also receive further evidence, recall witnesses or
recommit the matter to the magistrate judge with
instructions.

The failure to file timely objections to the foregoing Report and

Recommendation may constitute a waiver of any appellate rights.

Date: January 13, 2026 s/ Phillip J. Caraballo
Phillip J. Caraballo
United States Magistrate Judge

44