Case Name in Social Security Case - Unavailable

IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF PENNSYLVANIA
AMY HOLLINGER, 	: Civ. No. 1:24-CV-1833
:
Plaintiff, 	:
:
v. 	:
: (Chief Magistrate Judge Bloom)
FRANK BISIGNANO, 	:
Commissioner of Social Security,1 	:
:
Defendant. 	:
MEMORANDUM OPINION
I. 	Introduction
Amy Hollinger filed a Title II application for a period of disability
and disability insurance benefits on July 25, 2019,2 and added a Title XVI
application 	for 	supplementary 	security 	income 	on 	July 	31, 	2019.3
Following 	an 	initial 	hearing 	before 	an 	Administrative 	Law 	Judge
(“ALJ”), the ALJ found that Hollinger was not disabled from her alleged
1 On May 7, 2025, Frank Bisignano became the Commissioner of Social
Security. 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.
2 Tr. 428-31.
3 Tr. 432-38.
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onset date of disability of September 20, 2018, through May 24, 2021, the
date of the ALJ’s decision. 4 	On February 15, 2022, the Appeals Council
remanded the matter back to an ALJ for reconsideration. 5 Hollinger had
another hearing before an ALJ, 6 and following that hearing, the ALJ
published her decision finding that Hollinger was not disabled from her
alleged onset date of disability of September 20, 2018, through September
19, 2023, the date of that decision. 7
Hollinger now appeals this decision, arguing that the ALJ’s decision
is not supported by substantial evidence. 	After a review of the record,
and mindful of the fact that substantial evidence “means only—‘such
relevant evidence as a reasonable mind might accept as adequate to
support a conclusion,’”8 we conclude that substantial evidence supported
the ALJ’s findings in this case. 	Therefore, we will affirm the decision of
the Commissioner denying this claim.
4 Tr. 219-30.
5 Tr. 237-40.
6 Tr. 40-77.
7 Tr. 17-30.
8
Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019).
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II. 	Statement of Facts and of the Case
On 	July 	25, 	2019, 	Hollinger 	applied 	for 	disability 	insurance
benefits, 	and 	later 	added 	an 	application 	for 	supplemental 	security
income, citing an array of physical and mental impairments, including
osteoarthritis, degenerative disc and joint disease, congenial cervical
fusion, cervical spurs, pinched nerves from C6 to C7, fibromyalgia,
coronary artery disease, high blood pressure, irritable bowel syndrome
(“IBS”), sleep apnea, anxiety, depression, post-traumatic stress disorder
(“PTSD”), 	asthma, 	high 	cholesterol, 	carpel 	tunnel, 	cubical 	tunnel
syndrome, 	obesity, 	rhinitis, 	celiac 	disease, 	and 	lumbar 	stenosis. 9
Hollinger was 41 years old at the time of the alleged onset of disability,
had at least a high school education, and had past employment as a
housekeeper, bartender, school bus driver, and waitress.10
With 	respect 	to 	the 	alleged 	physical 	impairments 	the 	record
revealed the following: In February of 2018, Hollinger appeared for a
follow-up visit for her bypass surgery that occurred in 2016.11 Treatment
9 Tr. 472, 489.
10 Tr. 28-29.
11 Tr. 833.
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notes indicated her coronary disease and hypertension were controlled. 12
A few months later, Hollinger reported concerns of chest tightness, high
blood pressure, and hypertension. 13 A stress test revealed normal results
with no ischemia noted and her echocardiogram was unrevealing. 14
Hollinger’s symptoms improved after modifications were made to her
roughly 20 prescribed medications. 15
In May of 2018, Hollinger presented to Dr. Francis Gallagher at
Lebanon 	Internal 	Medicine 	Association, 	who 	noted 	her 	recent
hypertension and bradycardia episodes.16 	Dr. Gallagher further noted
that Hollinger’s fibromyalgia was stable and detailed her treatment,
which included duloxetine in combination with pregabalin, tizanidine, a
narcotic regimen, and injections as needed.17 	Hollinger reported overall
improvement with her pain. 18
12 Tr. 835.
13 Tr. 841.
14 Tr. 848.
15 Tr. 859-61, 885.
16 Tr. 856.
17
Id.
18
Id.
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In November of 2018, Hollinger returned to Dr. Gallagher for
complaints of chronic widespread pain. 19 	Hollinger reported significant
pain involving the cervical spine, which radiated into her upper back and
extremities causing paresthesias in her forearms. 20 	Dr. Gallagher noted
multiple tender fibromyalgia trigger points and increased her pregabalin
from 76 mg to 150 mg twice a day.21 	He ordered an X-ray of the cervical
spine, which showed congenital fusion of C6-7 and moderate spondylitic
hypertrophy or foraminal narrowing at C5-6 level on each side.22 	Six
months later, Dr. Gallagher increased Hollinger’s duloxetine from 90 mg
to 120 mg per day after she reported no change in her symptoms.23
From 2019 to 2023, Hollinger underwent multiple procedures to
address her pain, including medial branch blocks and radio frequency
ablations. 24 	In August of 2019, an MRI of Hollinger’s cervical spine
19 Tr. 691, 908.
20
Id.
21 Tr. 692, 909.
22 Tr. 694.
23 Tr. 698, 964.
24 Tr. 1017, 1031, 1042, 1054, 1064, 1159, 1169, 1448, 2804, 2836, 2838,
2934, 3021, 3069, 3122, 3141, 3389.
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showed cervical degenerative disc disease/osteoarthritis.25 Hollinger was
prescribed physical therapy, which only provided temporary relief of her
symptoms. 26 	However, 	treatment 	records 	indicate 	Hollinger’s 	pain
improved from the ablation therapy. 27
Hollinger appeared for a follow-up visit for her obstructive sleep
apnea in September of 2020, where she reported having trouble with her
CPAP mask at night. 28 	Hollinger received a new mask, which she
indicated worked well for her and denied daytime sleepiness.29 	After a
July 2021 sleep study, Hollinger switched from a CPAP to BiPAP. 30
In November of 2020, Hollinger reported worsening symptoms of
pain 	in 	her 	neck 	and 	lower 	back. 31 	Dr. 	Gallagher 	increased 	her
pregabalin dosage to 225 mg twice a day.32 	In May of 2021, Hollinger
continued complaints of back pain. 33 	Updated X-rays of the cervical
25 Tr. 1172-73, 1240.
26 Tr. 1431, 1437, 1461.
27 Tr. 1939, 1943, 2625, 2662.
28 Tr. 1822.
29 Tr. 2341-42.
30 Tr. 2321.
31 Tr. 1939.
32 Tr. 1940.
33 Tr. 2453.
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through 	lumbar 	regions 	were 	ordered 	and 	revealed 	no 	significant
changes. 34 	In August of 2021, Hollinger reported that her back pain was
slightly improved from her last visit and that she did not have any neck
and shoulder pain.35
In February of 2022, Hollinger continued reports of head-to-toe
chronic 	pain 	despite 	unchanged 	imaging 	results.36 	However, 	her
symptoms began to improve later that year, and her physical exams
demonstrated she had normal range of motion, strength, and sensation
in all extremities, and normal coordination and gait throughout the
relevant 	period. 37 	In 	August 	of 	2022, 	Hollinger 	reported 	positive
improvement in her pain. 38 	Treatment notes in November of 2022 also
indicate Hollinger had “major improvement in her symptoms.” 39 Indeed,
Hollinger rated her pain a three out of ten on May 10, 2023. 40
34 Tr. 2454-60.
35 Tr. 2463.
36 Tr. 2466-68.
37 Tr. 1939, 2087-88, 2096, 2108, 2208, 2486, 2872, 3106-07, 3481, 3567.
38 Tr. 2475.
39 Tr. 2481-82.
40 Tr. 2815.
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The record also indicates that Hollinger suffered from obesity
during the relevant period, having a body mass index that varied from
38.9 to 48.47 and pursuing bariatric surgery during this time. 41
With respect to Hollinger’s alleged mental impairments, Hollinger
was diagnosed with depression in or around 2016.42 	In June of 2018,
Hollinger reported her depression was stable. 43 	In 2019, Hollinger
indicated she did not struggle with having little interest in doing things
and did not feel down, depressed, or hopeless.44 	From 2020 to 2022,
Hollinger 	reported 	worsening 	symptoms 	of 	her 	depression 	due 	to
increased stress stemming from the COVID-19 pandemic, caring for her
parents, and relationship issues. 45 	However, treatment records during
this period also convey that Hollinger denied anxiety, depression, and
suicidal thoughts. 46 	Her medications were increased, which provided
41 Tr. 839, 874, 894, 904, 934, 949, 2157, 2190, 2513, 2581, 2600, 2644,
2683, 2687, 2817.
42 Tr. 613.
43 Tr. 868-69.
44 Tr. 959, 1887.
45 Tr. 2519, 2532, 2534, 2539, 2559, 2567, 2580, 2643, 2669, 2682-83.
46 Tr. 1856, 1872, 2197, 2207, 2220, 2231, 2499, 2906, 2916, 2925, 2937,
2947, 2957, 2966, 2978, 2987, 2996, 3005, 3014, 3024, 3042, 3053, 3061,
3072, 3082, 3091, 3104, 3115.
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some improvement in her symptoms.47 	In November of 2022, Hollinger
reported she was doing well on her medication. 48 	In May of 2023,
Hollinger’s depression was reported as stable.49
It is against this factual backdrop that the ALJ conducted a hearing
in Hollinger’s case on August 8, 2023. 50 Hollinger and a vocational expert
(“VE”) both testified at this hearing. 	Hollinger testified about her work
history, 	increased 	treatment 	and 	medications, 	and 	the 	increased
symptoms relating to her weight gain, migraines, IBS, COPD, sleep
apnea, fatigue, and depression.51 The VE in his testimony first classified
Hollinger’s past work, then answered hypothetical questions about an
individual with Hollinger’s background and specific types of limitations.52
Following this hearing, on September 19, 2023, the ALJ issued a
decision denying Hollinger’s application for benefits. 53 	In that decision,
the 	ALJ 	first 	concluded 	that 	Hollinger 	met 	the 	insured 	status
47 Tr. 2690, 2703.
48 Tr. 2776, 2794.
49 Tr. 2798, 2818.
50 Tr. 40-77.
51 Tr. 50-63.
52 Tr. 63-74.
53 Tr. 17-30.
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requirement through December 31, 2018.54 	At Step 2 of the sequential
analysis that governs Social Security cases, the ALJ found Hollinger
suffered 	from 	the 	following 	severe 	impairments:
osteoarthritis/degenerative joint disease, cervical degenerative disease,
fibromyalgia, obesity, obstructive sleep apnea, asthma, and coronary
artery disease.55 	At Step 3 the ALJ determined that Hollinger did not
have 	an 	impairment 	or 	combination 	of 	impairments 	that 	met 	or
medically equaled the severity of one of the listed impairments.56
Between Steps 3 and 4 the ALJ concluded that Hollinger retained
the following residual functional capacity to:
[P]erform light work as defined in 20 CFR 404.1567(b) and
416.967(b) except the claimant can stand/walk for only 4
hours and sit for only 4 hours during an 8-hour workday; can
occasionally climb ramps/stairs, balance, stoop, kneel, and
crouch; can never crawl or climb ladders/ropes/scaffolds; must
avoid concentrated exposure to extreme cold, heat, wetness,
humidity, fumes, odors, dusts, gases, poor ventilation, and
hazards such as unprotected machinery; can tolerate no more
than moderate noise intensity levels; and should avoid work
outdoors in bright sunshine and work with bright or flickering
lights as would be experienced in welding or cutting metals. 57
54 Tr. 20.
55 Tr. 20-22.
56 Tr. 22-23.
57 Tr. 23-28.
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In reaching this RFC determination, the ALJ made the following
findings: the ALJ considered Hollinger’s reported, subjective symptoms,
and found that “claimant’s medically determinable impairments could
reasonably be expected to cause the alleged symptoms; however, the
claimant’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[.]”58
The ALJ considered evidence of Hollinger’s activities of daily living,
and found that, taken together, they “suggest the claimant has retained
a greater capacity for exertional activities than alleged” as described in
the RFC. 59 	The ALJ then embarked on a review of the medical record
evidence she found supported those findings.60
The ALJ next considered the medical opinions on record. 61 She was
persuaded by the opinions of the state agency medical consultants, Drs.
Hong Park and Lelwellyn Raymundo, who opined that Hollinger was
58 Tr. 24.
59 Tr. 24-25.
60 Tr. 25-27.
61 Tr. 27-28.
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capable of a range of light exertional work activity involving postural and
environmental limitations. 62 The ALJ found the opinions to be consistent
with 	the 	physical 	examination 	records 	and 	Hollinger’s 	admissions
regarding her retained capacity for daily living. 63
The ALJ also found a mental health opinion of the state agency
psychological consultant, Dr. Edward Jonas, to be persuasive. 64 	Dr.
Jonas opined that Hollinger’s mental impairment was non-severe given
she had only mild limitations in any area of the work-related cognitive,
social, executive, or adaptive functioning. 65
The ALJ then found at Step 4 that Hollinger could not perform her
past work but, at Step 5, found that she could perform other occupations
with jobs that existed in significant numbers in the national economy,
such as marker, information clerk, and garment sorter.66 Having reached
these conclusions, the ALJ determined that Hollinger had not met the
62 Tr. 28, 168-73, 205-12.
63 Tr. 28.
64
Id.
65 Tr. 166-67.
66 Tr. 28-29.
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demanding showing necessary to sustain this claim for benefits and
denied this claim.
This 	appeal 	followed. 67 	On 	appeal, 	Hollinger 	challenges 	the
adequacy of the ALJ’s decision arguing it is not supported by substantial
evidence. 68 	As discussed in greater detail below, having considered the
arguments of counsel and carefully reviewing the record, we conclude
that the ALJ’s decision should be affirmed, and this appeal denied.
III. 	Discussion
A. Substantial Evidence Review – the Role of this Court
This Court’s review of the Commissioner’s decision to deny benefits
is limited to the question of whether the findings of the final decision-
maker are supported by substantial evidence in the record.69 	Substantial
evidence “does not mean a large or considerable amount of evidence, but
rather such relevant evidence as a reasonable mind might accept as
67 Doc. 1.
68 Doc. 14.
69
See 42 U.S.C. §405(g);
Johnson v. Comm’r of Soc. Sec., 529 F.3d 198,
200 (3d Cir. 2008);
Ficca v. Astrue, 901 F. Supp. 2d 533, 536 (M.D. Pa.
2012).
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adequate to support a conclusion.” 70 	Substantial evidence means less
than a preponderance of the evidence but more than a mere scintilla.71
A single piece of evidence is not substantial evidence if the ALJ
“ignores, 	or 	fails 	to 	resolve, 	a 	conflict 	created 	by 	countervailing
evidence.”72 	However, where there has been an adequately developed
factual record, substantial evidence may be “something less than the
weight of the evidence, and the possibility of drawing two inconsistent
conclusions from the evidence does not prevent [the ALJ’s decision] from
being supported by substantial evidence.” 73 	The court must “scrutinize
the record as a whole” to determine if the decision is supported by
substantial evidence. 74
The Supreme Court has explained the limited scope of our review,
noting 	that 	“[substantial 	evidence] 	means—and 	means 	only—‘such
relevant evidence as a reasonable mind might accept as adequate to
70
Pierce v. Underwood, 487 U.S. 552, 565 (1988).
71
Richardson v. Perales, 402 U.S. 389, 401 (1971).
72
Mason v. Shalala, 994 F.2d 1058, 1064 (3d Cir. 1993) (quoting
Kent v.
Schweiker, 	710 	F.2d 	110, 	114 	(3d 	Cir. 	1983)) 	(internal 	quotations
omitted).
73
Consolo v. Fed. Maritime Comm’n, 383 U.S. 607, 620 (1966).
74
Leslie v. Barnhart, 304 F. Supp.2d 623, 627 (M.D. Pa. 2003).
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support a conclusion.’”75 	Under this standard, we must look to the
existing 	administrative 	record 	to 	determine 	if 	there 	is 	“‘sufficient
evidence’ to support the agency’s factual determinations.”76 	Thus, the
question before us is not whether the claimant is disabled, but rather
whether the Commissioner’s finding that he or she is not disabled is
supported 	by 	substantial 	evidence 	and 	was 	based 	upon 	a 	correct
application of the law. 77
When conducting this review, we must remain mindful that “we
must not substitute our own judgment for that of the fact finder.” 78 Thus,
we cannot re-weigh the evidence. Instead, we must determine whether
75
Biestek, 139 S. Ct. at 1154 (quoting
Consolidated Edison Co. v. NLRB,
305 U.S. 197, 229 (1938)).
76
Id.
77
See Arnold v. Colvin, No. 3:12-CV-02417, 2014 WL 940205, at *1 (M.D.
Pa. Mar. 11, 2014) (“[I]t has been held that an ALJ’s errors of law denote
a 	lack 	of 	substantial 	evidence”) 	(alterations 	omitted);
	Burton 	v.
Schweiker, 512 F. Supp. 913, 914 (W.D. Pa. 1981) (“The Secretary’s
determination as to the status of a claim requires the correct application
of the law to the facts”);
see also Wright v. Sullivan, 900 F.2d 675, 678
(3d Cir. 1990) (noting that the scope of review on legal matters is
plenary);
Ficca, 901 F. Supp. 2d at 536 (“[T]he court has plenary review
of all legal issues . . . .”).
78
Zirnsak v. Colvin, 777 F.3d 607, 611 (3d Cir. 2014) (citing
Rutherford
v. Barnhart, 399 F.3d 546, 552 (3d Cir. 2005)).
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there is substantial evidence to support the ALJ’s findings. 	In doing so,
we must also determine whether the ALJ’s decision meets the burden of
articulation necessary to enable judicial review; that is, the ALJ must
articulate the reasons for his decision.79 	This does not require the ALJ
to use “magic” words, but rather the ALJ must discuss the evidence and
explain the reasoning behind his or her decision with more than just
conclusory 	statements. 80 	Ultimately, 	the 	ALJ’s 	decision 	must 	be
accompanied by “a clear and satisfactory explication of the basis on which
it rests.” 81
B. Initial Burdens of Proof, Persuasion, and Articulation for the
ALJ
To receive disability benefits under the Social Security Act, a
claimant must show that he or she is unable to “engage in any substantial
gainful activity by reason of any medically determinable physical or
mental impairment which can be expected to result in death, or which
has lasted or can be expected to last for a continuous period of not less
79
Burnett v. Comm’r of Soc. Sec. Admin., 220 F.3d 112, 119 (3d Cir. 2000).
80
See Diaz v. Comm’r of Soc. Sec., 577 F.3d 500, 504 (3d Cir. 2009)
(citations omitted).
81
Cotter v. Harris, 642 F.2d 700, 704 (3d Cir. 1981).
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than 12 months.” 82 This requires a claimant to show a severe physical or
mental impairment that precludes him or her from engaging in previous
work or “any other substantial gainful work which exists in the national
economy.” 83 	To receive benefits under Title II of the Social Security Act,
a claimant must show that he or she is under retirement age, contributed
to the insurance program, and became disabled prior to the date on which
he or she was last insured. 84
In 	making 	this 	determination, 	the 	ALJ 	follows 	a 	five-step
evaluation. 85 	The 	ALJ 	must 	sequentially 	determine 	whether 	the
claimant: (1) is engaged in substantial gainful activity; (2) has a severe
impairment; (3) has a severe impairment that meets or equals a listed
impairment; (4) is able to do his or her past relevant work; and (5) is able
to do any other work, considering 	his or her age, education, work
experience and residual functional capacity (“RFC”).86
82 42 U.S.C. §423(d)(1)(A); 42 U.S.C. §1382c(a)(3)(A);
see also 20 C.F.R.
§§404.1505(a), 416.905(a).
83 	42 	U.S.C. 	§423(d)(2)(A); 	42 	U.S.C. 	§1382c(a)(3)(B); 	20 	C.F.R.
§§404.1505(a), 416.905(a).
84 42 U.S.C. §423(a); 20 C.F.R. §404.131(a).
85 20 C.F.R. §§404.1520(a), 416.920(a).
8620 C.F.R. §§404.1520(a)(4), 416.920(a)(4).
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Between Steps 3 and 4, the ALJ must also determine the claimant’s
residual functional capacity (RFC). 	RFC is defined as “that which an
individual is still able to do despite the limitations caused by his or her
impairment(s).”87 	In making this assessment, the ALJ must consider all
the claimant’s medically determinable impairments, including any non-
severe impairments identified by the ALJ at step two of his or her
analysis. 88 	Our review of the ALJ’s determination of the plaintiff’s RFC
is deferential, and that determination will not be set aside if it is
supported by substantial evidence. 89
The claimant bears the burden at Steps 1 through 4 to show a
medically 	determinable 	impairment 	that 	prevents 	him 	or 	her 	from
engaging in any past relevant work. 90 	If met, the burden then shifts to
the Commissioner to show at Step 5 that there are jobs in significant
numbers 	in 	the 	national 	economy 	that 	the 	claimant 	can 	perform
87
	Burnett, 220 F.3d at 121 (citations omitted);
	see also 20 C.F.R. §
404.1545(a)(1).
88 20 C.F.R. §§404.1545(a)(2), 416.945(a)(2).
89
Burns v. Barnhart, 312 F.3d 113, 129 (3d Cir. 2002).
90
Mason, 994 F.2d at 1064.
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consistent 	with 	the 	claimant’s 	RFC, 	age, 	education, 	and 	work
experience. 91
With 	respect 	to 	the 	RFC 	determination, 	courts 	have 	followed
different paths when considering the impact of medical opinion evidence
on this determination. 	While some courts emphasize the necessity of
medical opinion evidence to craft a claimant’s RFC, other courts have
taken the approach that “[t]here is no legal requirement that a physician
have made the particular findings that an ALJ adopts in the course of
determining an RFC.” 92 	Additionally, in cases that involve no credible
medical opinion evidence, courts have held that “the proposition that an
ALJ must always base his RFC on a medical opinion from a physician is
misguided.” 93
Given these differing approaches, we must evaluate the factual
context 	underlying 	an 	ALJ’s 	decision. 	Cases 	that 	emphasize 	the
importance of medical opinion support for an RFC assessment typically
91 20 C.F.R. §§404.1512(f), 416.912(f);
Mason, 994 F.2d at 1064.
92
Titterington v. Barnhart, 174 F. App’x 6, 11 (3d Cir. 2006);
see also
Biller v. Acting Comm’r of Soc. Sec., 962 F. Supp. 2d 761, 778–79 (W.D.
Pa. 2013).
93
Cummings v. Colvin, 129 F. Supp. 3d 209, 214–15 (W.D. Pa. 2015).
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arise in the factual setting where well-supported medical sources have
found limitations to support a disability claim, but an ALJ has rejected
the medical opinion based upon an assessment of other evidence. 94 These
cases simply restate the notion that medical opinions are entitled to
careful consideration when making a disability determination. 	On the
other hand, when no medical opinion supports a disability finding or
when an ALJ relies upon other evidence to fashion an RFC, courts have
routinely sustained the ALJ’s exercise of independent judgment based
upon all the facts and evidence. 95 	Ultimately, it is our task to determine,
considering 	the 	entire 	record, 	whether 	the 	RFC 	determination 	is
supported by substantial evidence. 96
C. Legal 	Benchmarks 	for 	the 	ALJ’s 	Assessment 	of 	Medical
Opinions.
The plaintiff filed this disability application in July of 2019 after
Social 	Security 	Regulations 	regarding 	the 	consideration 	of 	medical
opinion evidence were amended. Prior to March of 2017, the regulations
94
Biller, 962 F. Supp. 2d at 778–79.
95
See Titterington, 174 F. App’x 6;
Cummings, 129 F. Supp. 3d at 214–
15.
96
Burns, 312 F.3d 113.
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established a hierarchy of medical opinions, deeming treating sources to
be the gold standard. 	However, in March of 2017, the regulations
governing the treatment of medical opinions were amended. 	Under the
amended regulations, ALJs are to consider several factors to determine
the persuasiveness of a medical opinion: supportability, consistency,
relationship with the claimant, specialization, and other factors tending
to support or contradict a medical opinion. 97
Supportability and consistency are the two most important factors,
and an ALJ must explain how these factors were considered in his or her
written decision. Supportability means “[t]he more relevant the objective
medical evidence and supporting explanations . . . are to support his or
her medical opinion(s) . . . . the more persuasive the medical opinions . . .
will be.” 98 	The consistency factor focuses on how consistent the opinion
is 	“with 	the 	evidence 	from 	other 	medical 	sources 	and 	nonmedical
sources.” 99
97 20 C.F.R. § 404.1520c(c).
98 20 C.F.R. §§ 404.1520c(c)(1), 416.920c(c)(1).
99 20 C.F.R. §§ 404.1520c(c)(2), 416.920c(c)(2).
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While there is an undeniable medical aspect to the evaluation of
medical opinions, it is well settled that “[t]he ALJ – not treating or
examining physicians or State agency consultants – must make the
ultimate disability and RFC determinations.” 100 	When confronted with
several medical opinions, the ALJ can choose to credit certain opinions
over others but “cannot reject evidence for no reason or for the wrong
reason.” 101 Further, the ALJ can credit parts of an opinion without giving
credit to the whole opinion and may formulate a claimant’s RFC based
on different parts of different medical opinions, so long as the rationale
behind the decision is adequately articulated.102 	On the other hand, in
cases 	where 	no 	medical 	opinion 	credibly 	supports 	the 	claimant’s
allegations, “the proposition that an ALJ must always base his RFC on a
medical opinion from a physician is misguided.” 103
100
Chandler v. Comm’r of Soc. Sec., 667 F.3d 356, 361 (3d Cir. 2011).
101
Mason, 994 F.2d at 1066
102
See Durden v. Colvin, 191 F. Supp. 3d 429, 455 (M.D. Pa. 2016).
103
Cummings, 129 F. Supp. 3d at 214–15.
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D. This Case Will Be Affirmed.
Our review of the ALJ’s decision denying an application for benefits
is significantly deferential. Our task is simply to determine whether the
ALJ’s decision is supported by substantial evidence in the record; that is
“only— ‘such relevant evidence as a reasonable mind might accept as
adequate to support a conclusion.’”104 	Judged against this deferential
standard of review, we conclude that substantial evidence supported the
ALJ’s decision in this case.
Hollinger first argues that the ALJ erred by relying on outdated
state 	agency 	opinions. 	She 	claims 	new 	evidence 	demonstrated 	a
worsening condition of her cervicalgia chronic pain, sacroiliitis, and
lumbar 	spondylosis, 	which 	was 	not 	present 	at 	the 	time 	of 	their
assessments. 105 	Hollinger details the evidence as follows:
Treatment 	notes 	following 	October 	2020 	document 	the
worsening of Ms. Hollinger’s cervicalgia, lumbar spondylosis,
and 	morbid 	obesity- 	In 	October 	2020, 	Ms. 	Hollinger
underwent radiofrequency ablation at C4/5, C5/6, and C6/7
levels on the left. In November 2020, Ms. Hollinger affirmed
neck and low back pain. She indicated that while cervical
ablation provided some relief but had no relief from sacroiliac
104
Biestek, 139 S. Ct. at 1154.
105 Doc. 14 at 3-7.
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injections. 	She 	exhibited 	multiple 	trigger 	points 	and
diminished 	patellar 	reflexes 	bilaterally. 	Her 	pregabalin
dosage was increased. In May 2021, Ms. Hollinger underwent
lumbar radiofrequency ablation at L3/4, l4/5, and L5/S1 levels
on the left. In July 2021, Ms. Hollinger reported bilateral SI
joint pain, migraine headaches, and diffuse body aches. She
weighed 255 pounds and had a BMI over 48 kg/m2. She was
diagnosed with fibromyalgia and morbid obesity. In May
2021, Ms. Hollinger affirmed back pain, sleep difficulties,
morning 	stiffness, 	and 	left-hand 	swelling. 	She 	exhibited
diminished patellar reflexes, multiple trigger points, knee
crepitus, 	tenderness 	over 	SI 	joints, 	and 	positive 	FABER
maneuver. Updated imaging studies and Case 1:24-cv-01833-
DFB Document 14 Filed 05/12/25 Page 4 of 21 5 lab work was
ordered. Cervical x-ray revealed fusion at C6-7, discogenic
disease and body spondylosis at the mid and cervical levels,
and 	facet 	arthropathy. 	Lumbar 	x-ray 	showed 	multilevel
discogenic disease and bony spondylitic changes. July 2021
pelvic x-ray showed 14 mm focus of increased signal involving
the right ilium adjacent to the right SI joint on a single coronal
fatsuppressed 	T2 	image. 	July 	2021 	sleep 	study 	revealed
obstructive 	sleep 	apnea. 	In 	July 	2021, 	Ms. 	Hollinger
underwent cardiac catheterization due to acute chest pain. In
July 	2021, 	Ms. 	Hollinger 	underwent 	bilateral 	SI 	joint
injections which provided relief for 24 hours for bilateral low
back pain and buttock pain. In October 2021, Ms. Hollinger
underwent 	right 	L3-S1 	medial 	branch 	radiofrequency
ablation. 	Id. 	Between 	August 	2021 	and 	June 	2023, 	Ms.
Hollinger attended physical therapy sessions for cervicalgia
and morbid obesity. In February 2022, Ms. Hollinger reported
head to toe pain. She had a lot of pain especially in the low
back radiating towards the hips and pelvis, with prolonged
morning stiffness. Her medications were reviewed. In March
2022, 	Ms. 	Hollinger 	affirmed 	pain 	in 	her 	neck, 	back,
shoulders, SI joints, and hips, depressed mood, anxiety, and
nervousness. 	She 	was 	diagnosed 	with 	fibromyalgia 	and
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recurrent 	major 	depression. 	In 	July 	2022, 	Ms. 	Hollinger
underwent 	bilateral 	C507 	medial 	branch 	radiofrequency
ablation. In April 2023, Ms. Hollinger continued to report
chronic pain in Case 1:24-cv-01833-DFB Document 14 Filed
05/12/25 Page 5 of 21 6 her neck, low back, hips, left knee, and
ankles. She exhibited antalgic gait and pain with cervical and
lumbar range of motion. She was diagnosed with chronic pain
syndrome, 	sacroiliitis, 	and 	lumbar 	spondylosis.
Radiofrequency 	ablation 	was 	ordered. 	In 	June 	2023, 	Ms.
Hollinger underwent cervical radiofrequency ablation at C5-6
and C6-7 levels.106
“The Social Security regulations impose no limit on how much time
may pass between a report and the ALJ’s decision in reliance on it.”107 It
is “[o]nly where ‘additional medical evidence is received that in the
opinion of the [ALJ] . . . may change the State agency medical . . .
consultant’s finding that the impairment(s) is not equivalent in severity
to any impairment in the Listing,’ is an update to the report required.” 108
Nevertheless, “where evidence can be read to indicate that a plaintiff's
condition deteriorated after the state agency reviewer issued his opinion,
106 Doc. 14 at 4-6.
107
Chandler v. Comm’r of Soc. Sec., 667 F.3d 356, 361 (3d Cir. 2011).
108
Id. (quoting SSR 96–6p (July 2, 1996) (emphasis added)).
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. . . the ALJ’s reliance on that opinion [may be] troubling.” 109 Ultimately,
an “ALJ’s reliance on the opinion of a reviewing consultant who did not
have all relevant records requires thorough explanation.”110
Hollinger cites to a plethora of abnormal treatment records dated
after the consultants’ findings in arguing that reliance on their opinions
was improper. 	However, the ALJ considered the findings in the record
regarding the claimant’s treatment post-dating the consultant’s opinions,
noting that Hollinger’s testing returned normal, she demonstrated full
strength 	in 	all 	extremities 	with 	little 	impairment 	to 	her 	reflexes,
sensation, and gait, and that she reported improvement with her pain. 111
Moreover, the ALJ explicitly noted she did not give the medical opinions
109
Batdorf v. Colvin, 206 F. Supp. 3d 1012, 1024 (M.D. Pa. 2016) (internal
quotations omitted);
see also Garcia v. Dudek, No. 1:24-CV-00194, 2025
WL 674226, at *9 (M.D. Pa. Mar. 3, 2025) (collecting cases).
110
Batdorf, 206 F. Supp. 3d at 1024–25;
see also Burton v. Kijakazi, No.
20-196, 2022 WL 125368, at *2 (W.D. Pa. Jan. 13, 2022) (“The ALJ . . .
clearly considered the record postdating the consultant’s opinion . . . and
adequately explained his reasons for accepting or rejecting pertinent
parts of the record.).
111
See Tr. 25-26.
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any 	specific 	or 	controlling 	weight 	prior 	to 	considering 	them. 112
Accordingly, we find no basis for a remand here.
Hollinger also claims the ALJ erred in finding her depression was
a non-severe impairment at Step 2. 	At Step 2, the ALJ determines
whether a claimant has a medically severe impairment or combination of
impairments.113 	An impairment is considered severe if it “significantly
limits an individual’s physical or mental abilities to do basic work
activities,” 114 or if it is “something beyond ‘a slight abnormality which
would have no more than a minimal effect on an individual’s ability to
work.’” 115 	This Step 2 inquiry is a de minimis screening device used to
112 Tr. 27;
see also Saeed v. Saul, No. CV 18-113, 2019 WL 2602143, at *4
(W.D. Pa. June 25, 2019) (finding remand not appropriate on this basis
given the ALJ only accorded the state agency consultant’s opinion partial
weight given their inability to review all treatment records).
113
Bowen v. Yuckert, 482 U.S. 137, 140-41 (1987).
114 20 C.F.R. 404.1520(c).
115
McCrea v. Comm’r of Soc. Sec., 370 F.3d 357, 360 (3d Cir. 2004)
(citations omitted).
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cast out meritless claims. 116 The claimant bears the burden to show that
an impairment should be considered severe.117
Here, the ALJ adequately explained why she found Hollinger’s
depression to be a non-severe impairment. The ALJ detailed the medical
record, including the medical opinion evidence, regarding Hollinger’s
mental health impairments. 	The ALJ noted Hollinger’s reports of mood
swings, depressed moods, and crying spells,118 but further noted that
other 	than 	routine 	and 	conservative 	treatment, 	which 	caused 	her
symptoms to be well-controlled and stable, the record contains minimal
evidence of any impairments to Hollinger’s attention, concentration, or
memory. 119 	Indeed, the ALJ recognized Hollinger’s reported ability to
perform a wide range of daily activities and return to school to study
criminal justice, evincing her cognitive ability to “concentrate, focus, and
remember.” 120 	Additionally, 	the 	ALJ 	acknowledged 	Dr. 	Haggard’s
116
McCrea, 370 F.3d at 360;
Newell v. Comm’r of Soc. Sec., 347 F.3d
541, 546 (3d Cir. 2003).
117
Bowen, 482 U.S. at 146;
Stancavage v. Saul, 469 F. Supp. 3d 311,
331 (M.D. Pa. 2020).
118 Tr. 24.
119 Tr. 21-22.
120 Tr. 22, 26-27.
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opinion regarding Hollinger’s mental health impairments, which she
found was unpersuasive and not supported by the longitudinal record. 121
Ultimately, the ALJ found that Hollinger’s depression was non-severe.
Given that it is the claimant’s burden to prove that an impairment is
severe at Step 2, we conclude that the ALJ’s Step 2 decision is supported
by substantial evidence and does not require a remand.
Hollinger further argues that the jobs of a garment sorter and
marker are outdated and obsolete. She claims the job of a marker is
“performed differently in today’s workforce than described by the . . .
[Dictionary of Occupational Titles (“DOT”)]” and is “performed at the
semiskilled to skilled levels” according to the Occupational Information
Network (“O*NET”).122 	Moreover, she claims the closest comparable job
to 	a 	garment 	sorter 	on 	O*NET 	is 	“51-9190.00—Helpers-Production
Workers,” which indicates a specific vocational preparation of 4 to < 6. 123
However, courts in our circuit “have been hesitant to reject the testimony
of Vocational Experts relying upon the DOT in favor of the descriptions
121 Tr. 27-28.
122 Doc. 14 at 11.
123
Id.
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on O*NET, given the fact that ‘Social Security Ruling 00-4P sets forth
that the relevant inquiry is whether VE testimony is consistent with the
DOT.’” 124 “[T]he regulations simply do not require a [Vocational Expert’s]
testimony to be consistent with O*Net.”125 	We agree with this body of
caselaw and conclude that the ALJ fulfilled her requirement under the
controlling regulations.
Lastly, Hollinger challenges the ALJ’s assessment of her obesity.
She argues that the ALJ failed to include analysis of the cumulative
impact of obesity and other impairments, and failed to consider SSR 19-
2p, 	which 	discusses 	postural 	limitations 	in 	the 	context 	of 	obesity.
Specifically, she alleges that the ALJ did not adequately explain how her
obesity 	was 	considered 	in 	combination 	with 	cervicalgia, 	lumbar
spondylosis, chronic pain syndrome, and sleep apnea.126
Under the agency’s regulations, the ALJ must analyze the effects of
a 	claimant’s 	obesity 	on 	his 	or 	her 	ability 	to 	function. 127 	This 	is
124
Pollock v. O’Malley, No. 1:22-cv-1856, 2024 WL 4803530, at *19 (M.D.
Pa. Nov. 15, 2024) (collecting cases).
125
Id. at *20.
126 Doc. 14 at 14-15.
127
See SSR 02-01p, SSR 00-3p.
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particularly so when the ALJ identifies the claimant’s obesity as a severe
impairment at Step 2.128 	The Third Circuit has explained that the ALJ
need not “use particular language or adhere to a particular format in
conducting his analysis” of a claimant’s obesity.129 Rather, so long as the
ALJ 	“meaningfully 	consider[s] 	the 	effect 	of 	a 	claimant’s 	obesity,
individually and in combination with her impairments, on her workplace
function at step three and at every subsequent step[,]” 130 a remand is not
required. 131
Here, the ALJ acknowledged obesity as a severe impairment and
discussed this impairment at Step 3, explicitly noting that she considered
SSR 19-2p regarding the claimant’s obesity and any impact it has on her
other impairments in determining whether it met or medically equaled a
listing. 132 	Further, in determining Hollinger’s RFC, the ALJ recounted
the medical records that documented Hollinger’s obesity in her discussion
128
Diaz v. Comm’r of Soc. Sec., 577 F.3d 500, 504 (3d Cir. 2009).
129
Diaz, 577 F.3d at 504 (citations omitted).
130
Id. at 504.
131
See Woodson v. Comm’r Soc. Sec., 661 F. App’x 762, 765 (3d Cir.
2016);
Cooper v. Comm’r of Soc. Sec., 563 F. App’x 904, 911 (3d Cir.
2014).
132 Tr. 23.
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of medical evidence, referring to Hollinger’s body mass index of 39.5
during the relevant period. 133 This evidence was discussed in conjunction
with the claimant’s physical examination findings, both normal and
abnormal, during the relevant period. 134 	These references are sufficient
to evince consideration of obesity in combination with other impairments,
and of obesity’s relationship to possible postural limitations. 	Thus, we
conclude there was no error in the ALJ’s treatment of obesity.
Accordingly, under the deferential standard of review that applies
to appeals of Social Security disability determinations, we conclude that
substantial evidence supported the ALJ’s evaluation of this case, and this
decision should be affirmed.
133 Tr. 25.
134 Tr. 24-27.
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IV. 	Conclusion
For the foregoing reasons, the decision of the Commissioner in this
case will be AFFIRMED, and the plaintiff’s appeal denied.
An appropriate order follows.
Submitted this 17th day of February 2026.
s/ Daryl F. Bloom
Daryl F. Bloom
Chief United States Magistrate Judge
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