Case Name in Social Security Case - Unavailable

UNITED STATES DISTRICT COURT
SOUTHERN DISTRICT OF OHIO
EASTERN DIVISION
MADALYNNE E. H., 1
Plaintiff,
v.
COMMISSIONER OF SOCIAL
SECURITY,
Defendant.
Case No. 2:24-cv-4126
JUDGE DOUGLAS R. COLE
Magistrate Judge Deavers
OPINION AND ORDER
The Magistrate Judge’s November 6, 2025, Report and Recommendation
(R&R, Doc. 15), advises this Court to affirm the Commissioner of Social Security’s
(Commissioner) decision denying Plaintiff Madalynne E. H. social security insurance
disability benefits (DIB) and supplemental security income (SSI). For the reasons
below, the Court OVERRULES Plaintiff’s Objections (Doc. 16), ADOPTS the R&R
(Doc. 15), and AFFIRMS the Commissioner’s decision.
BACKGROUND
Plaintiff believes that she is disabled as the Social Security Administration
(SSA) defines that term. She applied for social security disability benefits in October
2021. (Doc. 15, #3274). SSA personnel denied her claim initially in December 2021,
and then again upon reconsideration in April 2022. (Id.). Plaintiff challenged that
decision before an SSA Administrative Law Judge (ALJ), who presided over a
1 Due to privacy concerns, this Court refers to social security claimants only by their first
names and last initials. See S.D. Ohio General Order 22-01.
Case: 2:24-cv-04126-DRC-SCS Doc #: 19 Filed: 03/18/26 Page: 1 of 12 PAGEID #: <pageID>

2
telephone hearing at which Plaintiff was represented by counsel. (Id.). Plaintiff
testified, as did a vocational expert. (Id.). The ALJ issued a written decision on
October 25, 2023, finding that Plaintiff was not disabled within the meaning of the
Social Security Act. (Id.). The SSA Appeals Council declined review and adopted the
ALJ’s decision as the Commissioner’s final decision. (Id.). So the substance of the
ALJ’s decision is what provides the basis for review here.
In 	that 	decision, 	after 	finding 	that 	Plaintiff 	meets 	the 	insured-status
requirements of the Social Security Act through March 31, 2022, the ALJ proceeded
to consider the five-step “sequential evaluation process” that determines whether a
Social Security claimant is disabled as the Social Security Act uses that term. (Id. at
#3278 & n.1 (citations omitted)). Those factors direct ALJs to consider whether:
(1) the claimant is engaged in substantial gainful activity, (2) the claimant suffers
from one or more severe impairments, (3) the claimant’s severe impairments, alone
or in combination, meet or equal the criteria of impairment set forth in the
Commissioner’s Listing of Impairments, 20 C.F.R., Subpart P, Appendix 1; (4) the
claimant can perform her relevant past work, considering the claimant’s residual
functional capacity; and (5) the claimant can perform other work available in the
national economy, considering the claimant’s age, education, past work experience,
and residual functional capacity. 20 C.F.R. § 404.1520(a)(4); Foster v. Halter, 279 F.3d
348, 354 (6th Cir. 2001).
At step one of the analysis, the ALJ found that Plaintiff had not engaged in
substantially gainful activity since September 1, 2019. (Doc. 15, #3278). At step two,
Case: 2:24-cv-04126-DRC-SCS Doc #: 19 Filed: 03/18/26 Page: 2 of 12 PAGEID #: <pageID>

3
the ALJ found that Plaintiff has the following severe impairments: diabetes with
associated ketoacidosis, hyperglycemia, and hypoglycemia. (Id.). At step three, the
ALJ found that Plaintiff did not have an impairment or combination of impairments
that met or medically equaled one of the listed impairments described in 20 C.F.R.,
Part 404, Subpart P, Appendix 1. (Id.). At step four, the ALJ laid out Plaintiff’s
residual functional capacity (RFC), as that term is defined at 20 C.F.R. §§ 404.1567(b)
and 416.967(b). (Id. at #3279). He concluded that Plaintiff had the capacity to perform
light work, but must avoid hazards, such as unprotected heights and dangerous
machinery, and must avoid commercial driving. (Id.). The ALJ also concluded that
Plaintiff has no past relevant work. (Id. at #3279). Finally, at step five, the ALJ
determined that Plaintiff can perform other jobs that exist in significant numbers in
the national economy such as a “hand packer, mail clerk, or garment folder.” (Id.).
Thus, the ALJ concluded that Plaintiff was not disabled under the Social Security Act
at any time since September 1, 2019. (Id.).
Plaintiff initiated the instant case on November 4, 2024. (Doc. 1). In her
Statement of Specific Errors (Doc. 10), Plaintiff argued that the ALJ violated 20
C.F.R. § 404.1520c when evaluating a medical opinion from Simona Moore, “a
certified 	nurse 	practitioner 	[who] 	was 	the 	central 	hub 	for 	all 	of 	[Plaintiff’s]
treatment.” (Id. at #3249). Plaintiff explains that, in all claims filed on or after March
27, 2017, § 404.1520c “is the regulation the governs how opinion evidence is to be
evaluated.” (Id.). The regulation provides that the Commissioner “will not defer or
give any specific evidentiary weight, including controlling weight, to any medical
Case: 2:24-cv-04126-DRC-SCS Doc #: 19 Filed: 03/18/26 Page: 3 of 12 PAGEID #: <pageID>

4
opinion(s) or prior administrative medical finding(s), including those from … medical
sources.” 20 C.F.R. § 404.1520c(a). Rather, the Commissioner must evaluate those
opinions using five factors: (1) supportability, (2) consistency, (3) the relationship of
the source to the claimant, (4) specialization, and (5) other factors tending to support
or 	contradict 	a 	medical 	opinion 	or 	prior 	administrative 	medical 	finding. 	Id.
§§ 404.1520c(c)(1)–(5), 416.920c(c)(1)–(5). Plaintiff contends that the ALJ erred in his
consideration of the supportability and consistency factors, (Doc. 10, #3251)—the
“most important factors,” 20 C.F.R. §§ 404.1520c(b)(2), 416.920c(b)(2). Indeed, unlike
the other three factors, the regulations expressly require ALJs to “explain how [they]
considered the supportability and consistency factors for a medical source’s medical
opinions or prior administrative medical findings” in a benefits determination. 2 Id.
§§ 404.1520c(b)(2), 416.920c(b)(2).
The medical opinion at issue comes in the form of a short letter from Moore,
the body of which states as follows:
This is a note to confirm that [Plaintiff] suffers from the following
disorders: 	Anxiety, 	depression, 	Post 	Traumatic 	Stress 	Disorder,
Trichotillomania 	(hair 	pulling 	disorder), 	Type 	1 	Diabetes 	with
fluctuating glucose, abdominal bloating and pain from unknown cause.
Due to the nature of these conditions, [Plaintiff] has been unable to
sustain work due to frequent absences and the inability to predict when
she have [sic] a complication from these disease states.
2 Unless, that is, two or medical opinions or prior administrative medical findings are equal
in supportability and consistency “but are not exactly the same.” 20 C.F.R. §§ 404.1520c(b)(3),
416.920c(b)(3). In that case, the ALJ must also articulate how the ALJ considered the other
most persuasive factors. 20 C.F.R. §§ 404.1520c(b)(3), 416.920c(b)(3).
Case: 2:24-cv-04126-DRC-SCS Doc #: 19 Filed: 03/18/26 Page: 4 of 12 PAGEID #: <pageID>

5
It is myopinion [sic] that Miss Hall is not able to sustain employment
successfully at this time. If you have any questions in this regard, please
do not hesitate to call me.
(Doc. 7-2, #2155).
In his opinion, the ALJ said the following regarding Moore’s letter:
In May 2023, Simona Moore, CNP, summarized the claimant’s disorders
of anxiety, depression, posttraumatic stress disorder, trichotillomania,
type 1 diabetes, abdominal bloating, and pain from unknown cause,
which resulted in the claimant’s inability to sustain work due to
frequent absences and the inability to predict when she would have a
complication from her disease states (Ex. 24F). Ms. Moore opined that
the claimant was unable to sustain employment successfully (Ex. 24F).
As I noted above, such a statement is “reserved to the Commissioner”
and 	not 	to 	be 	evaluated 	for 	persuasiveness. 	With 	respect 	to 	the
assessment of the need for frequent absences, Ms. Moore did not provide
detailed analysis regarding the claimant’s frequent medical visits and
did not address the claimant’s non-compliance and frequent marijuana
use. Accordingly, she did not provide significant support for the need for
absences, and such a need is inconsistent with the above-summarized
normal physical exam findings, diagnostic imaging and test results, and
activities of living when claimant has been compliant with treatment.
Accordingly, I do not find the suggestion that the claimant requires
frequent absences to be persuasive.
(Doc. 7, #50).
Plaintiff’s Statement of Specific Errors argues that the ALJ erred in failing to
sufficiently articulate why he was rejecting Moore’s opinion. (Doc. 10, #3251).
According to Plaintiff, “[t]he ALJ focused exclusively on the lack of explanation” from
Moore. (Id.). In Plaintiff’s view, that’s a problem because “[t]he ALJ was not restricted
to the letter on which … Moore provided her opinion.” (Id.). Rather, the “[t]he ALJ
needed to review the entire record and determine whether there was evidence that
was supportive of and consistent with … Moore’s opinion regarding absenteeism.”
(Id.).
Case: 2:24-cv-04126-DRC-SCS Doc #: 19 Filed: 03/18/26 Page: 5 of 12 PAGEID #: <pageID>

6
The Magistrate Judge disagreed with Plaintiff’s characterization of the ALJ’s
decision. (Doc. 15, #3288). In the R&R, the Magistrate Judge points out that the ALJ
did, in fact, consider other record evidence, including prior administrative medical
findings, albeit not in the specific paragraph quoted above. (Id. at #3286–88). Thus,
in the Magistrate Judge’s view, “[t]he ALJ’s consideration of … Moore’s opinion and
the prior administrative medical findings complied with the appropriate regulations
and is supported by substantial evidence.” (Id. at #3287). Plaintiff filed timely
objections (Doc. 16), essentially reiterating the argument that Plaintiff offered in her
Statement of Specific Errors (Doc. 10).
The Commissioner replied to Plaintiff’s objections. (Doc. 17). There, the
Commissioner defended the R&R and the ALJ, arguing both properly evaluated
Moore’s medical opinion.
With that, the matter is ripe for review.
LEGAL STANDARD
If a party objects within the allotted time to a report and recommendation, the
court “shall make a de novo determination of those portions of the report or specified
proposed findings or recommendations to which objection is made.” 28 U.S.C.
§ 636(b)(1)(C); see also Fed. R. Civ. P. 72(b). Upon review, the court “may accept,
reject, or modify, in whole or in part, the findings or recommendations made by the
magistrate judge.” 28 U.S.C. § 636(b)(1).
But that is not the only relevant standard of review. In this case, the
Magistrate Judge reviewed a decision by a Social Security Administration ALJ that
Case: 2:24-cv-04126-DRC-SCS Doc #: 19 Filed: 03/18/26 Page: 6 of 12 PAGEID #: <pageID>

7
the Commissioner of the SSA adopted. In that setting, courts are “limited to
determining whether the Commissioner’s 	decision ‘is supported by substantial
evidence and was made pursuant to proper legal standards.’” Ealy v. Comm’r of Soc.
Sec., 594 F.3d 504, 512 (6th Cir. 2010) (quoting Rogers v. Comm’r of Soc. Sec., 486
F.3d 234, 241 (6th Cir. 2007)); see also 42 U.S.C. § 405(g) (“The findings of the
Commissioner of Social Security as to any fact, if supported by substantial evidence,
shall be conclusive.”). “Substantial evidence is such relevant evidence as a reasonable
mind might accept as adequate to support a conclusion.” Ealy, 594 F.3d at 512
(quotation omitted). So long as substantial evidence supports the Commissioner’s
conclusion, the court must affirm, even if substantial evidence in the record would
also support a different conclusion. Id. That said, even if substantial evidence
supports the ALJ’s decision, the court cannot affirm if “the SSA fails to follow its own
regulations and where that error prejudices a claimant on the merits or deprives the
claimant of a substantial right.” Rabbers v. Comm’r of Soc. Sec., 582 F.3d 647, 651
(6th Cir. 2009) (quoting Bowen v. Comm’r of Soc. Sec., 478 F.3d 742, 746 (6th Cir.
2007)).
Putting all that together, when a party specifically objects, this Court reviews
that portion of the R&R de novo to assess whether (1) the Magistrate Judge correctly
determined that the ALJ’s decision applied the correct legal standards (including the
SSA’s own regulations), and (2) substantial evidence supported the ALJ’s decision.
Case: 2:24-cv-04126-DRC-SCS Doc #: 19 Filed: 03/18/26 Page: 7 of 12 PAGEID #: <pageID>

8
LAW AND ANALYSIS
For Social Security disability benefits, a disability is an “inability to engage in
any substantial gainful activity by reason of any medically determinable physical or
mental impairment which ... has lasted or can be expected to last for a continuous
period of not less than 12 months.” 42 U.S.C. § 423(d)(1)(A). As noted above, the SSA
developed a five-step analysis to tell whether an individual is disabled. See 20 C.F.R.
§§ 404.1520(a)(4), 416.920(a)(4). As relevant here, a claimant may not be gainfully
employed (step one) and must have one or more severe, medically determinable
physical 	or 	mental 	impairments 	(step 	two). 	See 	id. 	The 	SSA 	considers 	some
impairments, listed in a regulatory appendix, as so severe they automatically entitle
a claimant to benefits (step three). See id.
If, 	as 	here, 	the 	list 	does 	not 	contain 	the 	claimant’s 	impairment 	or 	its
equivalent, the SSA then considers whether the claimant can still work (steps four
and five). See id. That is, the SSA assesses the claimant’s “residual functional
capacity,” or RFC, often relying on medical and vocational experts to assist in that
determination. See id. Then, based on the claimant’s RFC, age, education, and work
experience, the SSA asks whether the claimant can either continue performing the
work they had done before, or perform some different job or jobs that exist in
significant numbers in the national economy. See id. If the claimant falls into either
bucket, the SSA will find the claimant not disabled. See id. Otherwise, the claimant
is disabled. See id.
In her Objections to the R&R, Plaintiff challenges the ALJ’s handling of
Moore’s medical opinion regarding Plaintiff’s absenteeism, just as she did in her
Case: 2:24-cv-04126-DRC-SCS Doc #: 19 Filed: 03/18/26 Page: 8 of 12 PAGEID #: <pageID>

9
Statement of Specific Errors (Doc. 10). (Doc. 16, #3292–93). Specifically, Plaintiff
argues that the ALJ and Magistrate Judge improperly applied the supportability and
consistency factors. So the Court reviews that objection de novo. But even reviewing
the issue de novo, the Court is in complete agreement with the Magistrate Judge.
Plaintiff contends that both the ALJ and the Magistrate Judge “required that
any support or explanation for [Moore’s] opinions be included in the letter that
contained her opinion.” (Id. at #3293 (citing Hutchinson v. Comm’r of Soc. Sec., No.
13-cv-4162, 2014 WL 4852269, at *7 (N.D. Ohio Sep. 29, 2014) (“[T]he Sixth Circuit
is very clear that the medical source is not required to include all the evidence
supporting his opinion within the four corners of that opinion.”)). Therefore, Plaintiff
says, the ALJ and Magistrate Judge “erred by restricting their evaluation of the
supportability factor to the four[]corners of … Moore’s opinion letter.” Id.
But neither the ALJ nor the Magistrate Judge made any such error. Under
the supportability factor, “[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 opinion(s) or prior administrative medical finding(s) will be.” 20 C.F.R.
§ 404.1520c(c)(1). Under the consistency factor, “[t]he more consistent a medical
opinion(s) or prior administrative 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 finding(s) will be.” Id. § 404.1520c(c)(2). And here,
the ALJ “summarized Plaintiff’s treatment, in which he notes the record documents
Case: 2:24-cv-04126-DRC-SCS Doc #: 19 Filed: 03/18/26 Page: 9 of 12 PAGEID #: <pageID>

10
substantially normal physical findings, except for mainly gastrointestinal complaints
when 	non-compliant 	with 	treatment.” 	(Doc. 	15, 	#3274). 	Specifically, 	the 	ALJ
considered the prior administrative medical findings of Mila Bacalla, M.D., and
Indira Jasti, M.D.;
I find the assessment of Dr. Bacalla and Dr. Jasti to be persuasive, as
they supported it with a summary of the physical evidence of record (Ex.
8A/2, 5–6) and a finding that the claimant’s statements were only
partially consistent, particularly noting that a physician suggested that
the claimant’s alleged frequent vomiting was due to marijuana use (Ex.
8A/4). Their assessment is also consistent with the updated longitudinal
treatment 	and 	examining 	record, 	as 	well 	as 	diagnostic 	imaging,
laboratory findings, and biopsy results, as summarized above, which
document that the claimant’s condition has not generally resulted in
acute 	distress, 	particularly 	when 	she 	has 	been 	compliant 	with
treatment. Indeed, a June 2023 treatment note indicated that she was
doing very well with respect to glucose levels when she had her insulin
pump on automated mode (Ex 30F/3).
(Doc. 	7, 	#50). 	The 	ALJ 	also 	“correctly 	noted 	the 	normal 	clinical 	findings 	on
examination,” and “properly considered the largely unremarkable objective imaging
and biopsies.” (Doc. 15, #3287 (citing the pertinent portions of the ALJ’s opinion,
which in turn contains numerous record citations to this evidence)).
True, the ALJ did not cite all this evidence in the paragraph where he discusses
Moore’s opinion. (Doc. 7, #50). But that paragraph expressly references the “above-
summarized normal physical exam findings, diagnostic imaging and test results, and
activities of living when claimant has been compliant with treatment,” and states
that Moore’s opinion is a poor fit with this evidence. (Id.). So substantial evidence
supports the ALJ’s opinion. And he was not required to re-evaluate all that evidence
in the context of discussing Moore’s medical opinion. See Booker R. v. Comm’r of Soc.
Sec., No. 3:22-cv-170, 2023 WL 4247312, at *5 (S.D. Ohio June 29, 2023) (“[T]he ALJ’s
Case: 2:24-cv-04126-DRC-SCS Doc #: 19 Filed: 03/18/26 Page: 10 of 12 PAGEID #: <pageID>

11
evaluation of the medical evidence earlier in the decision … suffices to allow this
Court to engage in meaningful review of the ALJ’s decision. And as discussed above,
the Court concludes that the ALJ complied with the applicable regulations when she
found that the State agency medical consultants’ findings were mostly persuasive,
and 	also 	that 	her 	analysis 	is 	supported 	by 	substantial 	evidence.”). 	So,
notwithstanding Plaintiff’s assertion to the contrary, the ALJ did, in fact, “evaluate
the entire record” in declining to find Moore’s medical opinion persuasive. (Doc. 16,
#3293). That in turn means that neither the ALJ nor the Magistrate Judge erred in
“restricting 	their 	evaluation 	of 	the 	supportability 	factor 	to 	the 	four[]corners
of … Moore’s opinion letter.” (Id.). In other words, even accepting Plaintiff’s legal
premise—that the ALJ needed to do more than merely look to the four corners of
Moore’s opinion to properly evaluate the supportability and consistency factors—the
administrative record does not support the conclusion that the ALJ failed to abide by
that requirement. And as that is Moore’s sole objection to the Magistrate Judge’s
R&R, her challenge falls short.
CONCLUSION
For these reasons, the Court OVERRULES Plaintiff’s Objection (Doc. 16),
ADOPTS the R&R (Doc. 15), and AFFIRMS the Commissioner’s decision. The Court
DIRECTS the Clerk to enter judgment and TERMINATE this matter from the
docket.
Case: 2:24-cv-04126-DRC-SCS Doc #: 19 Filed: 03/18/26 Page: 11 of 12 PAGEID #: <pageID>

12
SO ORDERED.
March 18, 2026
DATE 	DOUGLAS R. COLE
UNITED STATES DISTRICT JUDGE
UGLAS R. COLE
TED STATES DISTRICT J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	J	JU
Case: 2:24-cv-04126-DRC-SCS Doc #: 19 Filed: 03/18/26 Page: 12 of 12 PAGEID #: <pageID>