Hernandez v. Commissioner of Social Security

IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF TEXAS
DALLAS DIVISION
MIRELLA K. H., 	§
Plaintiff, 	§
§
V . 	§ 	Civil Action No. 3:24-CV-2585-K
§
COMMISSIONER, SOCIAL
SECURITY
§
§
ADMINISTRATION, 	§
Defendant. 	§
MEMORANDUM OPINION AND ORDER
Before the Court is this appeal of the denial of Plaintiff Mirella K. H.’s
application for Social Security supplemental income and disability benefits. 	See
generally Doc. No. 1 (Complaint) and Doc. No. 17 (Plaintiff’s Memorandum of Law).
The Court has carefully considered the parties’ briefs, the administrative record, and
the 	applicable 	law. 	For 	the 	following 	reasons, 	the 	Commissioner’s 	decision 	is
AFFIRMED.
I. Background
A. Procedural History
In April 2021, Plaintiff filed for both disability insurance benefits (“DIB”) and
supplemental security income (“SSI”) alleging a period of disability beginning in July
2020 due to COVID-19 complications, thrombosis, vision issues, brain fog, and
forgetfulness caused by low oxygen levels. 	Doc. No. 12-1 at 76. 	Plaintiff’s claim was
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denied at all administrative levels, and she now appeals to this Court under 42 U.S.C.
§ 405(g).
B. Factual History
Plaintiff, who was 43 years old at the alleged onset of her disability, has a tenth-
grade education and past relevant employment working in a warehouse as a child
monitor. Doc. No. 12-1 at 35, 256; Doc. No. 12-2 at 416. Plaintiff’s relevant medical
history, spanning from 2020 through 2024, reveals diagnoses of obesity and respiratory
complications resulting from Plaintiff’s prior COVID-19 infection. 	Doc. No. 12-2 at
290, 461-62, 593. In July 2020, Plaintiff was hospitalized and treated for COVID-19
pneumonia and acute respiratory failure after presenting to the ER with shortness of
breath. 	Doc. No. 12-1 at 401, 465. 	Upon discharge in August 2020, Plaintiff was
prescribed supplemental home oxygen at a rate of two liters per minute via nasal
cannula. Doc. No. 12-1 at 488.
C. Medical Opinion Evidence
In October 2021, Dr. Harar Yusuf, M.D., conducted a consultative medical
examination of Plaintiff. 	Doc. No. 12-2 at 355. 	At that time, Plaintiff reported
shortness of breath and was observed using portable oxygen at four liters per minute.
Doc. No. 12-2 at 355-56. 	On examination, Dr. Yusuf noted that Plaintiff’s oxygen
saturation was 98% on room air, and that she was alert, oriented, and in no apparent
distress. 	Doc. No. 12-2 at 356. 	Dr. Yusuf further observed that Plaintiff exhibited
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normal gait and was able to sit, stand, carry, handle objects, hear, and speak. Doc. No.
12-2 at 356. 	She was also able to walk on her toes and heels and could squat. 	Doc.
No. 12-2 at 356.
In January 2022, Plaintiff underwent a six-minute walk test. 	Doc. No. 12-2 at
406. 	Before the test, Plaintiff’s oxygen saturation measured 99% on room air. 	Doc.
No. 12-2 at 406. Her oxygen saturation decreased to 95% while walking but returned
to 99% following the test. Doc. No. 12-2 at 406. In total, Plaintiff walked 1,000 feet
in six minutes without stopping. Doc. No. 12-2 at 406. Following the exercise, Plaintiff
reported a headache and dizziness, however these symptoms improved with rest. Doc.
No. 12-2 at 406.
Between August 2022 and May 2023, Plaintiff’s oxygen saturation levels
repeatedly measured between 96% and 100% on room air. Doc. No. 12-2 at 437, 447,
472, 496, 506. 	During this period, Plaintiff was also described as alert and oriented
and as exhibiting a normal gait. 	Doc. No. 12-2 at 438, 483. 	Treatment notes from
September 2022 indicate that Plaintiff was not observed using supplemental oxygen,
although she continued to report shortness of breath. Doc. No. 12-2 at 445.
In August 2023, Plaintiff’s BMI was calculated at 39.1 and her oxygen saturation
was between 95% and 96% on room air. 	Doc. No. 12-2 at 531-33. 	Although she
stated she had difficulty breathing during exertion, Plaintiff reported that she had been
able to “wean off” daytime oxygen. Doc. No. 12-2 at 530-31.
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The 	following 	month, 	Plaintiff 	presented 	to 	pulmonologist 	Timothy 	R.
Chappell, M.D., to undergo a pulmonary function test. Doc. No. 12-2 at 593. Plaintiff
again reported that she had “slowly recovered” and no longer relied on portable oxygen
during the day, although she continued to use it at night. Doc. No. 12-2 at 593. Dr.
Chappell recorded Plaintiff’s oxygen saturation at 97% on room air. Doc. No. 12-2 at
592. 	However, he noted that her test results were consistent with dyspnea, which is
defined as “difficult or labored respiration,” on exertion and needing oxygen. Doc. No.
12-2 at 594-95; see Merriam-Webster Medical Dictionary, Merriam-Webster Online,
https://www.merriam-webster.com/dictionary/dyspnea (last visited Mar. 23, 2026).
D. Hearing Testimony
At the 2024 administrative hearing, Plaintiff testified that since contracting
COVID-19 in 2020, she requires supplemental oxygen and can no longer walk long
distances. 	Doc. No. 12-1 at 50. 	She averred that she becomes short of breath even
while sitting and that she will begin to cough if she talks too much. Doc. No. 12-1 at
55, 60. 	She further testified that she must use oxygen “all the time” and that the
longest she can go without wearing her oxygen is “maybe 30 minutes or hours.” Doc.
No. 12-1 at 50-51. 	She stated that the only time she is not hooked up to an oxygen
machine is when she uses the restroom, takes a shower, or cooks a meal. Doc. No. 12-
1 at 50-51.
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Plaintiff testified that her large oxygen machine weighs between 35 to 40 pounds
and, while she can wheel the machine around, she cannot climb stairs with it or place
it in her car. 	Doc. No. 12-1 at 51. Although she also has a portable oxygen machine,
Plaintiff averred that the device can only be used for an hour and a half before needing
charged. Doc. No. 12-1 at 52.
A vocational expert (“VE”) testified that an individual with Plaintiff’s education
and work experience who is limited to understanding, remembering, and carrying out
one 	and 	two 	step 	instructions; 	making 	simple 	decisions 	and 	simple 	judgments;
performing 	only 	light 	work; 	and 	only 	occasional 	exposure 	to 	hazards 	such 	as
unprotected heights, moving mechanical parts, and atmospheric conditions, could not
perform Plaintiff’s past work. 	Doc. No. 12-1 at 65. 	However, the VE testified that
such an individual could perform work in the national economy as a small parts
assembler, merchandise marker, or cafeteria attendant. Doc. No. 12-1 at 65. The VE
further testified that if the individual required a portable oxygen device while working,
its use would constitute an accommodation that could potentially be work preclusive,
as it would depend on whether an employer would permit it. Doc. No. 12-1 at 67-68.
E. The ALJ’s Findings
Following the administrative hearing, the ALJ issued his Hearing Decision
utilizing the five-step sequential evaluation set forth in 20 C.F.R. § 416.920 in
determining whether Plaintiff was disabled. 	At step one, the ALJ found that Plaintiff
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met the insured status requirements of the Social Security Act through September 30,
2027, and had not engaged in substantial gainful activity since July 29, 2020. 	Doc.
No. 12-1 at 24. 	At step two, the ALJ determined that Plaintiff had the severe
impairments of post COVID-19 syndrome, obesity, major depressive disorder, and
mixed anxiety and depressive disorder. Doc. No. 12-1 at 25. However, the ALJ further
found that none of Plaintiff’s impairments, singularly or in combination, met or
medically equaled any listed impairment. Doc. No. 12-1 at 25.
At step three, the ALJ found that Plaintiff had the Residual Functional Capacity
(“RFC”) to perform “light work . . . except: she can have occasional exposure to hazards
such as unprotected heights and moving mechanical parts; she can have occasional
exposure to atmospheric conditions; and she can understand, remember, and carry out
one and two-step instructions, make simple decisions, and make simple judgments.”
Doc. No. 12-1 at 27.
At step four, the ALJ found that Plaintiff did not have the RFC to perform her
past work. 	Doc. No. 12-1 at 34. 	At step five, the ALJ found that there were a
significant number of jobs in the national economy that Plaintiff could perform. Doc.
No. 12-1 at 34. The ALJ thus concluded that Plaintiff was not disabled under the Act.
Doc. No. 12-1 at 35.
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II. Applicable Law
The definition of disability under the Act is the “inability 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 than 12 months . . . .” 	42 U.S.C.
§ 423(d)(1)(A). 	To determine whether a claimant is disabled, the Commissioner
utilizes a sequential five-step inquiry: (1) whether the claimant is engaged in substantial
gainful activity; (2) whether the claimant’s impairments are “severe”; (3) whether the
claimant’s impairment “meets or equals” one of the listings in the relevant regulations;
(4) whether the claimant can still do her past relevant work; and (5) whether the
impairment prevents the claimant from doing any other available work. 	Webster v.
Kijakazi, 19 F.4th 715, 718 (5th Cir. 2021) (citing 20 C.F.R. § 404.1520(a)(4)). The
claimant bears the burden on the first four steps. Id. (citation omitted). If the claimant
meets her burden, the burden then shifts to the Commissioner to “prove the claimant’s
employability.” Id. (citation omitted).
The Court’s review “is exceedingly deferential and limited to two inquiries:
whether substantial evidence supports the ALJ’s decision, and whether the ALJ applied
the proper legal standards when evaluating the evidence.” 	Taylor v. Astrue, 706 F.3d
600, 602 (5th Cir. 2012). 	“And whatever the meaning of ‘substantial’ in other
contexts, the threshold for such evidentiary sufficiency is not high. 	Substantial
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evidence, [the Supreme] Court has said, is more than a mere scintilla. It means—and
means only—such relevant evidence as a reasonable mind might accept as adequate to
support a conclusion.” Biestek v. Berryhill, 587 U.S. 97, 103 (2019) (internal citations
and quotation marks omitted). 	The Court can neither “reweigh the evidence or
substitute its judgment for the Commissioner’s.” Perez v. Barnhart, 415 F.3d 457, 461
(5th Cir. 2005). A finding that substantial evidence does not exist “is appropriate only
if no credible evidentiary choices or medical findings support the decision.” Whitehead
v. Colvin, 820 F.3d 776, 779 (5th Cir. 2016) (cleaned up).
III. Analysis
On appeal, Plaintiff argues that the ALJ’s determination is not supported by
substantial evidence because (1) the RFC does not include Plaintiff’s use of medically
necessary supplemental oxygen; (2) the ALJ failed to adequately evaluate Plaintiff’s
subjective complaints; and (3) the RFC fails to properly consider how Plaintiff’s obesity
could affect her ability to work. Doc. No. 17 at 5. Upon review, the Court finds that
Plaintiff’s arguments lack merit.
A. The ALJ’s Rejection of Plaintiff’s Need for Supplemental Oxygen is
Supported by Substantial Evidence.
In her first issue on appeal, Plaintiff argues that the ALJ improperly relied on
mischaracterizations of the medical evidence in determining that she did not require
supplemental oxygen during the day. 	Doc. No. 17 at 15. 	Specifically, Plaintiff
contends that the ALJ selectively cited portions of the medical record to support this
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conclusion, while disregarding evidence indicating that Plaintiff used supplemental
oxygen and that such use was necessary. Doc. No. 17 at 15-19. The Court disagrees.
The RFC assessment is based on “all of the relevant evidence in the case record,”
including, but not limited to, medical history, medical signs and laboratory findings,
the effects of treatment, reports of daily activities, lay evidence, recorded observations,
medical source statements, and work evaluations. 	SSR 96-8p, 61 Fed. Reg. 34,477
(July 2, 1996), 1996 WL 362207. As factfinder, the ALJ has the sole responsibility for
weighing the evidence and determining the relative weight to be given it. Chambliss v.
Massanari, 269 F.3d 520, 523 (5th Cir. 2001). 	The ALJ is not required to include a
limitation in the RFC that he did not find supported by the record. 	Scott v. Comm’r,
Soc. Sec. Admin, No. 4:20-CV-1136, 2022 WL 4240888, at *5 (N.D. Tex. Sept. 14,
2022) (Cureton, J.) (citing Muse v. Sullivan, 925 F.2d 785, 790 (5th Cir. 1991)); see
Masterson v. Barnhart, 309 F.3d 267, 273 (5th Cir. 2002). However, in determining a
claimant’s RFC, the ALJ “must consider all the record evidence and cannot ‘pick and
choose’ only the evidence that supports his position.” Loza v. Apfel, 219 F.3d 378, 393
(5th Cir. 2000) (citations omitted).
In his decision, the ALJ thoroughly summarized the evidence bearing on
Plaintiff’s oxygen use, including records showing that she was prescribed home oxygen
at two liters per minute following her COVID-19 hospitalization in August and
September 2020. 	See Doc. No. 12-1 at 29-31. 	The ALJ also acknowledged that,
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between October and December 2020, Plaintiff both reported using portable oxygen
and was observed using oxygen therapy as recommended. 	Doc. No. 12-1 at 29. 	The
ALJ additionally noted that Plaintiff was seen using portable oxygen at a physical in
October 2021. Doc. No. 12-1 at 30.
The ALJ further explained, however, that later treatment notes from April and
September 2022 indicated that Plaintiff was no longer using supplemental oxygen at
her appointments. 	Doc. No. 12-1 at 29-30. 	The ALJ also observed that Plaintiff’s
oxygen saturation levels on room air have consistently measured above 95% since
December 2020, that multiple examinations reflected normal respiratory findings, and
that Plaintiff completed a six-minute walk test with her saturation dropping only to
95%. Doc. No. 12-1 at 29-31. Based on this objective medical evidence, the ALJ found
Plaintiff’s 	statements 	that 	she 	is 	dependent 	on 	supplemental 	oxygen 	were 	not
supported by her “longitudinal record.” Doc. No. 12-1 at 31.
Plaintiff asserts that the ALJ failed to give proper consideration to her only
pulmonary examination, conducted by Dr. Chappell in September 2023, because he
described the examination in a single paragraph and addressed it only to the extent it
“support[ed] his narrative.” 	Doc. No. 17 at 17. 	However, the ALJ noted the precise
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results of the pulmonary function test, including Plaintiff’s FVC, FEV1, and DLCO
values. Doc. No. 12-1 at 30.
Although the ALJ did not independently interpret these raw values, the ALJ is
not required to translate raw medical data into functional limitations without a
supporting medical opinion. See Hernandez v. O’Malley, No. 5:23-CV-1403, 2025 WL
899971, at *3 (W.D. Tex. Feb. 27, 2025) (explaining the difference between objective
medical evidence, which an ALJ is authorized to interpret, and raw medical data, which
he is not); Moore v. Saul, No. 3:20-CV-161, 2022 WL 987735, at * 3 (N.D. Miss. Mar.
31, 2022) (holding that the ALJ improperly interpreted medical data where the ALJ
drew conclusions from evidence wholly unconsidered by any medical expert, such as
plaintiff’s MRI results).
While Dr. Chappel appears to have handwritten the notes “severe restriction”
and “severe reduction DLCO” next to Plaintiff’s results, he did not provide an opinion
on how those findings transfer into functional limitations. 	See Doc. No. 12-2 at 581,
592-95. 	Instead, he noted only that the results of her pulmonary function test and
chest x-ray were “consistent with her DOE [dyspnea on exertion],” and “needing
oxygen.” 	Doc. 	No. 	12-2 	at 	594-95; 	see 	Merriam-Webster 	Medical 	Dictionary,
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https://www.merriam-webster.com/dictionary/doe#medicalDictionary 	(last 	visited
Mar. 23, 2026) [https://perma.cc/NP6Z-MYE6].
While this observation seemingly weighs in Plaintiff’s favor, other portions of
Dr. Chappel’s narrative notes contradict Plaintiff’s purported oxygen dependency. As
the ALJ observed, for example, Plaintiff reported that she “had slowly recovered from
her COVID, and she no longer chose to rely on portable oxygen during the day[.]”
Doc. No. 12-1 at 30 (citing Doc. No. 12-2 at 593). 	While Plaintiff objects that the
ALJ’s phrasing that she “had slowly recovered from her COVID” does not match the
precise language in Dr. Chappel’s note stating that she “has slow recovery,” this
distinction does not materially alter the substance of the report. 	Doc. No. 17 at 17
(citing Doc. No. 12-2 at 594). Moreover, an ALJ’s RFC determination need not mirror
or exactly match a medical professional’s opinion. Rater v. Comm’r of Soc. Sec., No. 7:24-
CV-142, 2025 WL 1287922, at *4, 7 (N.D. Tex. May 2, 2025) (Ray, J.) (citation
omitted).
Applying the deferential standard of review, the Court finds no basis to disturb
the ALJ’s determination that Plaintiff does not require supplemental oxygen. The ALJ
conducted a detailed analysis of the record, including reviewing evidence both favorable
and unfavorable to Plaintiff. The ALJ’s decision acknowledges the severity of Plaintiff’s
initial illness but reasonably relies on subsequent treatment notes showing that Plaintiff
was no longer using oxygen at appointments, consistently exhibited normal respiratory
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findings and oxygen saturation levels, and completed a six-minute walk test with only
minimal desaturation. 	See Doc. No. 12-1 at 31. 	While the ALJ did not recount
verbatim every piece of evidence in the record, it cannot be said that his decision was
based on a mischaracterization of the evidence. 	Again, “conflicts in the evidence are
for the Commissioner and not the courts to resolve.” 	Masterson v. Barnhart, 309 F.3d
267, 272 (5th Cir. 2002) (internal quotations omitted). 	Nor may the Court reweigh
the evidence or substitute its judgment for that of the Commissioner’s, “even if . . . the
evidence weighs against the Commissioner’s decision.” Id.
On this record, the Court concludes that the ALJ’s RFC is supported by
substantial evidence. Accordingly, remand is not required on this issue.
B. The ALJ Properly Evaluated Plaintiff’s Subjective Complaints.
Plaintiff also argues that the ALJ failed to adequately evaluate her subjective
complaints under the two-step framework set forth by the Social Security Regulations.
Doc. No. 17 at 20.
When a plaintiff alleges symptoms limiting her ability to work, she must first
establish a medically determinable impairment capable of producing those symptoms.
Ripley v. Chater, 67 F.3d 552, 556 (5th Cir. 1995) (citing 20 C.F.R. § 404.1529
(1994)). 	Once such an impairment is shown, the ALJ must evaluate the plaintiff’s
subjective complaints along with the available medical evidence in determining the
individual’s work capacity. Id. In conducting this analysis, the regulations provide that
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the ALJ must consider factors including the plaintiff’s daily activities, the location,
duration, frequency, and intensity of symptoms; precipitating and aggravating factors;
and the effectiveness of treatment, including medication or other measures. 20 C.F.R.
§§ 404.1529(c)(1), (c)(3), (d)(4). 	The ALJ must also consider inconsistencies in the
evidence and the existence of any conflicts between the plaintiff’s subjective statements
and the remainder of the evidence. §§ 404.1529(c)(4).
An individual’s statements about the intensity and persistence of symptoms
“may not be disregarded solely because they are not substantiated by objective medical
evidence.” 	SSR 	96-7p, 	1996 	WL 	374186 	(July 	2, 	1996) 	(emphasis 	added);
§ 404.1529(c)(2). However, “subjective evidence need not be credited over conflicting
medical evidence.” Anthony v. Sullivan, 954 F.2d 289, 295 (5th Cir. 1992) (citing Jones
v. Heckler, 702 F.2d 616, 621 n.4 (5th Cir. 1983)). The ALJ may determine, based on
his evaluation of the objective medical evidence, that an applicant’s complaints “are
not to be credited or are exaggerated.” 	Johnson v. Heckler, 767 F.2d 180, 182 (5th Cir.
1985). 	Because “the ALJ is best positioned” to assess the credibility of subjective
complaints, such determinations are entitled to “considerable deference.” 	Falco v.
Shalala, 27 F.3d 160, 164 (5th Cir. 1994); Wren v. Sullivan, 925 F.2d 123, 128-29 (5th
Cir. 1991).
Here, the ALJ recounted Plaintiff’s testimony that she could no longer work or
perform most daily activities due to her constant need for supplemental oxygen. Doc.
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No. 12-1 at 28. The ALJ also described Plaintiff’s statements that she suffered weekly
swelling of her legs, that she spends much of the day laying down, and that she is
anxious and depressed daily. 	Doc. No. 12-1 at 28. 	The ALJ further recounted a
Function Report in which Plaintiff wrote that she had to use supplemental oxygen
continuously, that she had a hard time dressing, bathing, and using the toilet, and that
her impairments limited her ability to lift, squat, bend, stand, walk kneel, climb stairs,
remember things, concentrate, and understand instructions. Doc. No. 12-1 at 28.
After summarizing this evidence and detailing Plaintiff’s medical records, the
ALJ concluded that although Plaintiff’s impairments could reasonably be expected to
cause the alleged symptoms, her statements concerning the persistence and limiting
effects of these symptoms were “not entirely consistent with the medical and other
evidence in the record.” 	Doc. No. 12-1 at 31. 	The ALJ then explained how specific
evidence 	was 	not 	consistent 	with 	Plaintiff’s 	statements 	regarding 	her 	need 	for
supplemental oxygen as well as her statements concerning her related mental and
physical limitations. See Doc. No. 12-1 at 31.
Plaintiff argues that the ALJ erred by discrediting her subjective complaints
“solely because the available objective medical evidence does not substantiate [them].”
Doc. No. 17 at 21. 	However, the ALJ did not rely exclusively on a lack of objective
support; 	rather, 	he 	identified 	inconsistencies 	and 	conflicts 	between 	Plaintiff’s
statements and the other evidence. See generally Doc. No. 12-1 at 31-32. Specifically,
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the 	ALJ 	noted 	that 	Plaintiff’s 	statements 	that 	she 	relies, 	or 	is 	dependent 	on
supplemental oxygen were not consistent with her prior reports to medical providers
that she had been able to wean herself off supplemental oxygen during the day, and
with notes observing that she left her oxygen in the car during her appointments. Doc.
No. 12-1 at 31. 	He further explained that Plaintiff’s alleged oxygen dependency was
not supported by her consistent oxygen saturation levels, and reports of normal
respiratory findings during examinations. Doc. No. 12-1 at 31.
Regarding 	Plaintiff’s 	alleged 	mental 	impairments, 	the 	ALJ 	noted 	that—
consistent with her testimony—the record included diagnoses of depression and
anxiety and there was evidence that Plaintiff intermittently presented with a depressed
mood and “abnormal” memory. Doc. No. 12-1 at 31. Plaintiff contends that the ALJ
inaccurately 	noted 	that 	the 	record 	did 	not 	include 	evidence 	of 	treatment 	with
psychotropic medications, however, the ALJ accurately recounted that Plaintiff did not
have a “longitudinal history of taking psychotropic medication.” 	Doc. No. 12-1 at 31.
As Defendant points out, this observation is consistent with record evidence indicating
that Plaintiff was prescribed a psychotropic medication on one occasion. See Doc. No.
12-2 at 309. 	Finally, the ALJ also observed that Plaintiff’s described psychological
symptoms were inconsistent with consultative examination findings that Plaintiff had
a normal thought process, normal thought content, and normal speech and with reports
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indicating that Plaintiff was noted as having a good mood and appropriate speech on
several occasions. Doc. No. 12-1 at 33.
While the ALJ must do more than merely recite the factors described for
evaluating a plaintiff’s subjective symptoms, there is no requirement that “every factor
must be discussed in detail in the determination.” 	Giles v. Astrue, 433 F. App’x 241,
249 (5th Cir. 2011) (citing Clary v. Barnhart, 214 F. App’x 479, 482 (5th Cir. 2007)
(“The ALJ is not required to mechanically follow every guiding regulatory factor in
articulating reasons for denying claims or weighing credibility.”)). Here, it is clear that
the ALJ considered Plaintiff’s subjective complaints and articulated in detail how they
were inconsistent with, or unsupported by, other evidence in the record. Although the
ALJ did not conduct a formalistic examination of each of the relevant factors, his
analysis sufficiently considered Plaintiff’s subjective complaints. See e.g., Lopez v. Astrue,
854 F. Supp. 2d 415, 424-25 (N.D. Tex. 2012) (finding that the ALJ properly
evaluated Plaintiff’s credibility by expressly acknowledging that he “experienced some
level of pain and functional loss, but concluded that [the] plaintiff’s subjective
complaints were out of proportion to the objective medical evidence”). 	Because the
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ALJ’s credibility findings in this regard are supported by substantial evidence, remand
is not required on this issue.
C. The ALJ Properly Considered Plaintiff’s Obesity.
In her final point of error, Plaintiff argues that the ALJ failed to adequately
evaluate the effects of Plaintiff’s obesity in assessing her RFC. 	Doc. No. 17 at 23.
Specifically, she contends that although the ALJ recognized her obesity as a severe
impairment at step two, he included no substantial discussion of the impairment or its
potential limiting effects. Doc. No. 17 at 23.
Although obesity is not itself an impairment, an ALJ must nevertheless assess
the impact of obesity on an individual’s RFC. 	SSR 19-2p, 2019 WL 2374244, at *4
(May 20, 2019). 	SSR 19-2p recognizes that individuals with obesity may experience
limitations in exertional functions, such as sitting, standing, walking, lifting carrying,
pushing and pulling, as well as nonexertional functions such as climbing, balancing,
stooping, kneeling, crouching, and crawling. Id. Further, because the effects of obesity
combined with other impairments “may be greater than the effects of each of the
impairments considered separately,” they must be evaluated together. Id.
As a preliminary matter, Plaintiff did not claim obesity as an impairment in her
initial application for disability benefits. 	See Doc. No. 12-1 at 76 (initial disability
determination noting that Plaintiff filed for disability on April 21, 2021, alleging
COVID-19, thrombosis, vision, brain fog and forgetfulness due to need for oxygen).
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Plaintiff likewise did not mention her obesity, or assert any limitations caused thereby
in her Adult Function Report. 	See Doc. No. 12-1 at 269-72 (writing that her
continuous need for oxygen limits her ability to work, go outside, and complete daily
tasks). 	Indeed, it appears that Plaintiff’s first reference to her obesity as a severe
impairment appeared in her brief submitted in advance of the February 2024 hearing.
See Doc. No. 12-1 at 317-318.
At the hearing, Plaintiff testified that she cannot walk long distances, and she
has trouble standing and sitting for long periods of time, however, she described these
limitations as caused by back pain, dizziness, and shortness of breath. Doc. No. 12-1
at 53-54, 59 (testifying that she can walk only a half mile or less before becoming short
of breath). She did not testify about how her weight affected her daily life, such as her
ability to walk, climb, lift, or sleep, see generally Doc. No. 12-1 at 50-60, and her counsel
appeared to focus solely on her oxygen related impairments, see Doc. No. 12-1 at 53,
73.
Accordingly, at the time the ALJ issued his decision, Plaintiff had presented only
objective medical evidence showing diagnoses of obesity. 	See e.g., Doc. No. 12-1 at
309. 	Based on this record, the ALJ listed Plaintiff’s obesity as a severe impairment at
step two of his analysis. Doc. No. 12-1 at 25. In determining Plaintiff’s RFC, the ALJ
acknowledged that obesity is no longer a listed impairment, however he stated that he
considered Plaintiff’s obesity “in relation to the musculoskeletal, respiratory, and
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cardiovascular systems” as required by the Social Security Rulings. 	Doc. No. 12-1 at
26. 	While still assessing Plaintiff’s RFC, the ALJ specifically mentioned that Plaintiff
has a body mass index exceeding 30.00 and is therefore considered obese. Doc. No. 12-
1 at 30. He also stated that “[i]n accordance with SSR 19-2,” he considered Plaintiff’s
obesity, acknowledging that it may affect her “ability to perform exertional functions—
e.g., sit, stand, walk, lift, carry, push, and pull—postural functions—e.g., climb, balance,
stoop, and crouch—manipulative functions—if there is fatty tissue in the hands and
fingers—and limit [Plaintiff’s] ability to tolerate certain environmental conditions.”
Doc. No. 18 at 8 (citing Doc 12-1 at 31). 	In the following paragraph, the ALJ noted
that during Plaintiff’s October 2021 physical consultation, she was “was able to sit,
stand, carry, handle objects,” was observed as exhibiting “a normal gait” and was able
to “top-toe walk, he[e]l walk, and squat.” 	Doc. No. 12-1 at 30 (citing Doc. No. 12-2
at 356). 	He also mentioned that Plaintiff had a normal range of motion, had 5/5
strength in her bilateral upper and lower extremities, exhibited no edema, her lungs
were clear, and no wheeze, crackle, or rhonchi were noted. Doc. No. 12-1 at 30 (citing
Doc. No. 12-2 at 356-57). The ALJ concluded that, considering Plaintiff’s examination
findings, in particular Plaintiff’s normal strength and gait, she retains the ability to
perform work at the “light exertional level.” Doc. No. 12-1 at 32.
In her brief, Plaintiff does not identify additional record evidence of how her
obesity 	impacts 	her functional 	abilities, nor 	does 	she 	argue 	that 	any particular
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limitations resulting from her obesity were omitted from her RFC. Doc. No. 17 at 23.
Instead, she argues generally that although the ALJ included “boilerplate” statements
that he considered the effects of Plaintiff’s obesity in accordance with SSR 19-2p, the
decision does not adequately reflect such consideration. 	Doc. No. 17 at 23. 	Plaintiff
relies primarily on Lupe V. v. Commissioner of Social Security, No. 3:23-CV-30, 2023 WL
1144235, at *4 (N.D. Tex. Mar. 14, 2024) (Toliver, J.), in support of her contention
that the ALJ’s consideration of her obesity was insufficient. 	Doc. No. 17 at 23. 	In
Lupe, the Court held that the ALJ failed to adequately assess the effect of the plaintiff’s
obesity on her other impairments in the RFC. 	2023 WL 1144235, at *4. 	Although
the ALJ found obesity, osteoarthritis, and depression to be severe impairments, the
decision offered only the conclusory statement that “the claimant’s knee impairment
and obesity warrant postural limitations,” without any further analysis. Id.
Here, however, after discussing the severity of Plaintiff’s obesity and the
potential for limitations therefrom, the ALJ expressly considered Plaintiff’s strength,
range of motion, and ability to ambulate, sit, stand, carry, and handle objects. 	Doc.
No. 12-1 at 30. 	Unlike in Lupe, he ultimately concluded that the record supported
Plaintiff’s ability to perform work at the light exertional level subject to limitations
relating to Plaintiff’s pulmonary issues. Doc. No. 12-1 at 31.
While Plaintiff now argues that her obesity has the potential to impact her
already present symptoms of fatigue, difficulty ambulating, and issues with routine
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movement stemming from residuals impact of her COVID infection, the ALJ rejected
these subjective symptoms in light of her October 2021 physical examination which
indicated that, while obese, Plaintiff exhibited no exertional limitations. Doc. No. 12-
1 at 30 (citing Doc. No. 12-2 at 356-57). Because Plaintiff presented no other evidence
as to the impact of her obesity on her other limitations or her ability to perform work
activities, the ALJ’s analysis was sufficient. 	See e.g., Perkins v. Berryhill, No. 4:18-CV-
664, 2019 WL 2997082, at *3 (N.D. Tex. June 21, 2019) (Cureton, J.), rep. & rec.
adopted 2019 WL 2996055 (N.D. Tex. July 9, 2019) (finding that the ALJ properly
considered the claimant’s obesity, despite the absence of an in-dept discussion, where
the ALJ referenced her body mass index and noted evidence that she could walk 30-40
minutes and perform household chores); Scott v. Colvin, 2013 WL 6047555, at *11
(S.D. Tex. Nov. 14, 2013) (finding the ALJ adequately addressed obesity by stating
that he considered it under the applicable regulations, but found “no evidence of any
significant disturbances of the musculoskeletal, respiratory, and /or cardiac systems
related to [the] obesity.”).
Even if the ALJ failed to adequately consider the cumulative effect of Plaintiff’s
obesity on her other limitations, Plaintiff has not shown that such error was sufficiently
prejudicial to warrant remand. 	Because procedural perfection is not required in
administrative proceedings, a court “will not vacate a judgment unless the substantial
rights of a party have been affected.” Kneeland v. Berryhill, 850 F.3d 749, 761 (5th Cir.
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2017) (citation and quotation marks omitted). However, when an ALJ fails to comply
with the regulations governing the evaluation of obesity, courts generally find that the
claimant has been prejudiced unless: “(1) the ALJ limits the claimant to sedentary work,
or (2) the record is totally devoid of medical evidence establishing any obesity related
limitations.” 	Walford v. Astrue, No. 3-09-CV-629, 2011 WL 2313012, at *5 (N.D.
Tex. June 10, 2011) (collecting cases).
Here, Plaintiff fails to identify any evidence in the record demonstrating the
effects of her obesity, and the Court is not aware of any physician assessment,
testimony, or other evidence indicating that Plaintiff’s obesity limits her functional
capacity or exacerbates her other limitations. 	In the absence of such evidence,
Plaintiff’s contention that her obesity would likely impact her ability to “sustain a
function over time” is purely speculative. 	See Vogt v. Astrue, No. 3:11-CV-315, 2011
WL 5245421, at *11 (N.D. Tex. Nov. 2, 2011) (Ramirez, J.) (finding plaintiff did not
meet her burden to show that her obesity impacted her work ability where she “fail[ed]
to cite to any evidence in the record” demonstrating that her obesity exacerbated or
imposed additional limitations on her other impairments”); Dennis v. Berryhill, No.
3:170CV0433, 2018 WL 1318982, at *8 (N.D. Tex. Mar. 13, 2018) (Ramirez, J.)
(finding ALJ’s alleged error in complying with a previous version of SSR 19-2p “merely
speculative” where none of the medical records identified any functional limitations
due to the claimant’s obesity and plaintiff did not allege any such limitations during
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the hearing before the ALJ); Salas v. Astrue, No. 4:07-CV-442, 2008 WL 5330517, at
*4 (N.D. Tex. Dec. 18, 2008) (Means, J.) (holding that the ALJ’s failure to expressly
address the claimant’s obesity was not reversible error where the plaintiff did not allege
obesity as a basis for her disability application and identified no medical source
attributing functional limitations to the condition).
While the ALJ owes a duty to fully and fairly develop the record, Plaintiff must
nevertheless supply some evidence demonstrating her disability. 	With respect to any
alleged disability resulting from her obesity, she has failed to meet this burden. Vogt v.
Astrue, 2011 WL 5245421, at *11. Thus, remand is not warranted on this issue.
IV. Conclusion
For the foregoing reasons, the Commissioner’s decision is AFFIRMED.
SO ORDERED.
Signed March 30th , 2026.
_________________________________________
ED KINKEADE
UNITED STATES DISTRICT JUDGE
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