Hamm v. Commissioner of Social Security

IN THE UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF OHIO
EASTERN DIVISION
JESSICA ERIN HAMM,
Plaintiff,
vs.
COMMISSIONER OF SOCIAL
SECURITY,
Defendant.
CASE NO. 1:25-cv-423
DISTRICT JUDGE
BRIDGET M. BRENNAN
MAGISTRATE JUDGE
JAMES E. GRIMES JR.
REPORT AND
RECOMMENDATION
Plaintiff Jessica Erin Hamm filed a complaint against the Commissioner
of Social Security seeking judicial review of the Commissioner’s decision
denying her applications for disability insurance benefits and supplemental
security income. This court has jurisdiction under 42 U.S.C. §§ 405(g) and
1383(c). The Court referred this matter to a Magistrate Judge under Local Rule
72.2(b)(1) for the preparation of a Report and Recommendation. Following
review, and for the reasons stated below, I recommend that the District Court
affirm the Commissioner’s decision.
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Procedural background
In 	August 	2022, 	Hamm 	filed 	applications 	for 	disability 	insurance
benefits and supplemental security income with a disability onset date1 of July
1, 2018, see Tr. 244, 254, which was later amended to August 30, 2022, see Tr.
45. In pertinent part, Hamm claimed that she was disabled and limited in her
ability to work due to the following medical conditions: degenerative disc
disease in cervical and lumbar spine, osteoarthritis of right knee, bilateral
carpal tunnel, fibromyalgia, diabetes mellitus, obesity, anxiety, post-traumatic
stress disorder, and migraines. See Tr. 281. The Commissioner denied Hamm’s
applications initially and on reconsideration. Tr. 137, 142, 150, 154.
In March 2023, Hamm requested a hearing. Tr. 241. In December 2023,
Administrative Law Judge (“ALJ”) Robert Tjapkes held a telephonic hearing.
Tr. 40–62. Watson appeared, testified, and was represented by counsel at the
December 2023 hearing. See Tr. 46. Qualified vocational expert Michelle Ross
also testified. Tr. 56. In February 2024, the ALJ issued a written decision
finding that Hamm was not entitled to benefits. Tr. 14–34.
In March 2024, Hamm appealed the ALJ’s decision to the Appeals
Council. See Tr. 7. In January 2025, the Appeals Council denied Hamm’s
appeal, making the ALJ’s February 2024 decision the final decision of the
Commissioner. Tr. 1–6; see 20 C.F.R. § 404.981.
1 	“Once a finding of disability is made, the [agency] must determine the
onset date of the disability.” McClanahan v. Comm’r of Soc. Sec., 193 F. App’x
422, 425 (6th Cir. 2006).
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Hamm timely filed this action in March 2025. Doc. 1. In it, she asserts
the following legal issue:
Whether the ALJ erred when failing to identify
substantial 	evidence 	supporting 	the 	residual
functional capacity findings regarding a cane and
nonexertional limitations resulting from Plaintiff’s
pain. Whether the ALJ erred in his evaluation of the
opinion 	of 	treating 	physician 	Paul Chang, 	M.D.
when failing to identify evidence inconsistent with
or unsupportive of the opinion.
Doc. 9, at 1.
Evidence2
Medical Evidence
In September 2022, Dr. Chang noted that Hamm presented with “pain
all over.” Tr. 375. He remarked that her comorbidities included: COPD,
hypertension, 	hyperlipidemia, 	obesity, 	chronic 	joint 	pains, 	fibromyalgia,
irritable bowel, and bipolar disorder. Id. Dr. Chang recorded that Hamm
weighed 284 pounds with a BMI of 46.7. Tr. 368. On examination, Dr. Chang
noted that Hamm appeared obese and had poor dentition, but that her mental
status and orientation were normal and her “level of distress” was comfortable.
Tr. 	376. 	Also 	in 	September 	2022, 	Dr. 	Chang 	prescribed 	a 	cane 	for
“intervertebral disc degeneration, lumbar region” and was instructed to “use
as directed.” See Tr. 3932. Dr. Chang’s appointment note from this time reflects
that Hamm had a wide gait and used a cane. Tr. 376.
2 	The evidence cited is generally limited to the evidence cited in the
parties’ briefs and relevant to the application period and arguments at issue.
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In December 2022, Dr. Chang noted that Hamm continued to be
“noncompliant and inconsistent with diet and diabetes management.” Tr. 747.
Dr. 	Chang’s 	physical 	examination 	findings 	were 	unchanged 	between
September and December 2022. Tr. 747–48.
In April 2023, Ami Hay, APRN-CNP3 treated Hamm for complaints of
thinning hair, weight gain, facial hair, and emotional issues. Tr. 2033. Nurse
Hay noted that Hamm reported going to the gym twice weekly over the
previous two months and that she had lost approximately 10 pounds. Id.
In August 2023, Tiffani Pinion, APRN-CNP, treated Hamm in a follow-
up appointment for sleep issues. Tr. 1415. Nurse Pinion remarked that Hamm
reported improvement with her daytime fatigue when she consistently used
breathing therapy. Id. Nurse Pinion performed a physical examination of
Hamm, which revealed normal musculoskeletal range of motion throughout,
no neurological deficits, and normal cardiovascular functioning. Tr. 1418.
In October 2023, Dr. Chang noted that Hamm was noncompliant with
her recommended diet and exercise and that she was inconsistent with her
efforts to manage her diabetes. Tr. 3955. Dr. Chang also recorded that Hamm
described recent falling episodes and that Hamm was “not using her cane
much,” despite reporting that she is “unsteady with her gait” and “clumsy and
3 	APRN is an abbreviation for Advanced Practice Registered Nurse.
Advanced 	Practice 	Registered 	Nurse 	(APRN), 	OhioAPRN.com,
http://www.ohioaprn.com/what-is-an-aprn-.html 	[https://perma.cc/69UR-
XX65]. CNP is an abbreviation for Certified Nurse Practitioner. Id.
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sometimes 	her 	feet 	and 	ankle 	would 	buckle 	without 	warning.” 	Id. 	On
examination, Dr. Chang indicated that Hamm had no neck tenderness, normal
cardiovascular testing, and normal motor strength and tone. Id. She did,
however, have tenderness and swelling in her right ankle joint and wide-based
gait with the use of a cane. Id.
In October 2023, orthopedist Thomas J. Seuzi, D.O., evaluated Hamm
for right ankle pain. Tr. 1787, 1790. Dr. Suezi noted that Hamm described
recurrent pain, with laxity in both ankles that caused her to fall, and that “she
uses a cane to assist with ambulation and prevent falls.” Tr. 1790.
In November 2023, Samantha E. Bark, DPM, treated Hamm for laxity
in both ankles. Tr. 3802. Dr. Bark noted that Hamm was “in no acute distress,”
instructed Hamm to “continue wearing the ankle lacer brace as needed,” and,
rather than pursuing surgery, prescribed physical therapy to strengthen the
ankle joint. Tr. 3810.
Opinion Evidence
In September 2022, Dr. Chang completed a residual functional capacity
questionnaire. Tr. 3899. Dr. Chang listed diagnoses of lumber degenerative
disc disease and joint pain. Id. Dr. Chang’s markings on the questionnaire
indicate his opinions that Hamm could: sit for six hours in an eight-hour
workday; stand for three hours in a workday, with rests every 15 minutes; walk
one hour in a workday, with rests every 15 minutes; occasionally lift and carry
10 pounds; occasionally bend; never squat, crawl, or climb; and miss four days
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of work monthly as a result of treatment or her impairments. Id. 	Dr. Chang
also opined that pain or other symptoms would continuously interfere with
Hamm’s ability to maintain attention and concentration to perform simple
work tasks. Id. Dr. Chang did not provide any citation to records or other
explanation for the limitations indicated on his questionnaire. Id.
State Agency Reviewers
In December 2022, state agency reviewing physician Steve McKee,
M.D., found that Hamm, could perform work at the light exertional level with
certain functional limitations. Tr. 94–95. Specifically, Dr. McKee opined that
Hamm could occasionally lift, carry, push, and pull 20 pounds and 10 pounds
frequently, and that she could sit, stand, and walk for no more than six hours
out of an eight-hour workday. Tr. 94. Dr. McKee also found that Hamm could
occasionally climb ramps or stairs, balance, stoop, kneel, crouch, or crawl, and
never climb ladders, ropes, or scaffolds. Tr. 94. Finally, Dr. McKee opined that
Hamm should avoid heavy machinery and unprotected heights. Tr. 95.
In April 2023, state agency reviewing physician Muraru Bijpuria, M.D.,
generally affirmed that Dr. McKee’s findings on reconsideration by finding that
Hamm could perform work at the light exertional level. Tr. 115. Dr. Bijpuria,
however, further limited Hamm to standing or walking for no more than three
hours out of an eight-hour workday. Tr. 115. Dr. Bijpuria also limited Hamm
to frequent overhead reaching and frequent handling and fingering bilaterally.
Tr. 116. And Dr. Bijpuria opined that Hamm should avoid unprotected heights,
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dangerous moving equipment, commercial driving, extreme cold, extreme heat,
humidity, and pulmonary irritants. Id.
ALJ’s Decision
The ALJ made the following findings of fact and conclusions of law:
1. 	The 	claimant 	meets 	the 	insured 	status
requirements 	of 	the 	Social 	Security 	Act
through June 30, 2023.
2. 	The claimant has not engaged in substantial
gainful activity since July 1, 2018, the alleged
onset date (20 CFR 404.1571 et seq., and
416.971 et seq.).
3. 	The 	claimant 	has 	the 	following 	severe
impairments: right knee degenerative joint
disease; 	cervical 	and 	lumbar 	degenerative
disc 	disease; 	diabetes 	mellitus 	with
peripheral 	neuropathy; 	chronic 	obstructive
pulmonary disorder (COPD); obesity; anxiety;
depression; 	posttraumatic 	stress 	disorder
(PTSD); and cannabis use disorder (20 CFR
404.1520(c) and 416.920(c)).
4. 	The claimant does not have an impairment or
combination of impairments that meets or
medically equals the severity of one of the
listed 	impairments 	in 	20 	CFR 	Part 	404,
Subpart P, Appendix 1 (20 CFR 404.1520(d),
404.1525, 404.1526, 416.920(d), 416.925 and
416.926).
5. 	After 	careful 	consideration 	of 	the 	entire
record, 	I 	find 	that 	the 	claimant 	has 	the
residual 	functional 	capacity 	to 	perform
sedentary 	work 	as 	defined 	in 	20 	CFR
404.1567(a) and 416.967(a) except that she
cannot climb ladders, ropes, or scaffolds and
cannot 	work 	around 	hazards 	such 	as
unprotected 	heights 	or 	unguarded 	moving
machinery. She must be allowed to use a cane
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for ambulation. The claimant can occasionally
crouch, crawl, kneel, stoop and occasionally
climb ramps and stairs, she can frequently
handle 	and 	finger 	and 	have 	occasional
exposure 	to 	occupational 	extremes 	of
atmospheric 	conditions 	as 	defined 	in 	the
Selected Characteristics of Occupations. The
claimant can have occasional interaction with
coworkers, supervisors, and the public. She
cannot perform production rate work (such as
on an assembly line) and can have occasional
changes in workplace setting.
6. 	The claimant is unable to perform any past
relevant 	work 	(20 	CFR 	404.1565 	and
416.965).
7. 	The claimant was born on December 20, 1978
and was 39 years old, which is defined as a
younger individual age 18-44, on the alleged
disability 	onset 	date. 	The 	claimant
subsequently 	changed 	age 	category 	to 	a
younger 	individual 	age 	45-49 	(20 	CFR
404.1563 and 416.963).
8. 	The 	claimant 	has 	at 	least 	a 	high 	school
education (20 CFR 404.1564 and 416.964).
9. 	Transferability of job skills is not material to
the determination of disability because using
the Medical-Vocational Rules as framework
supports a finding that the claimant is “not
disabled,” whether or not the claimant has
transferable job skills (See SSR 82-41 and 20
CFR Part 404, Subpart P, Appendix 2).
10. 	Considering the claimant’s age, education,
work 	experience, 	and 	residual 	functional
capacity, 	there 	are 	jobs 	that 	exist 	in
significant numbers in the national economy
that 	the 	claimant 	can 	perform 	(20 	CFR
404.1569, 404.1569a, 416.969, and 416.969a).
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11. 	The claimant has not been under a disability,
as defined in the Social Security Act, from
July 1, 2018, through the date of this decision
(20 CFR 404.1520(g) and 416.920(g)).
Tr. 20–34.
Standard for Disability
Eligibility for social security benefit payments depends on the existence
of a disability. 42 U.S.C. §§ 423(a), 1382(a). “Disability” is defined as 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); see also 42 U.S.C.
§ 1382c(a)(3)(A).
An ALJ is required to follow a five-step sequential analysis to make a
disability determination:
1. 	Is the claimant engaged in substantial gainful
activity? If so, the claimant is not disabled.
2. 	Does 	the 	claimant 	have 	a 	medically
determinable impairment, or a combination of
impairments, 	that 	is 	“severe”? 	If 	not, 	the
claimant is not disabled.
3. 	Does the claimant’s impairment meet or equal
one of the listed impairments and meet the
duration requirement? If so, the claimant is
disabled. If not, the ALJ proceeds to the next
step.
4. 	What is the claimant’s residual functional
capacity and can the claimant perform past
relevant 	work? 	If 	so, 	the 	claimant 	is 	not
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disabled. If not, the ALJ proceeds to the next
step.
5. 	Can 	the 	claimant 	do 	any 	other 	work
considering the claimant’s residual functional
capacity, 	age, 	education, 	and 	work
experience? If so, the claimant is not disabled.
If not, the claimant is disabled.
20 C.F.R. §§ 404.1520, 416.920; see Jordan v. Comm’r of Soc. Sec., 548 F.3d
417, 422 (6th Cir. 2008). Under this sequential analysis, the claimant has the
burden of proof at steps one through four. Jordan, 548 F.3d at 423. The burden
shifts to the Commissioner at step five “to prove the availability of jobs in the
national economy that the claimant is capable of performing.” Id. “The
claimant, however, retains the burden of proving her lack of residual functional
capacity.” Id. If a claimant satisfies each element of the analysis and meets the
duration requirements, the claimant is determined to be disabled. Walters
Comm’r of Soc. Sec., 127 F.3d 525, 529 (6th Cir. 1997).
Standard of Review
A reviewing court must affirm the Commissioner’s conclusions unless it
determines “that the ALJ has failed to apply the correct legal standards or has
made findings of fact unsupported by substantial evidence in the record.”
Jordan, 548 F.3d at 422. “‘[S]ubstantial evidence’ is a ‘term of art’” under which
“a court … asks whether” the “existing administrative record … contains
‘sufficien[t] evidence’ to support the agency’s factual determinations.” Biestek
v. Berryhill, 587 U.S. 97, 102 (2019) (citations omitted). The substantial
evidence standard “is not high.” Id. at 103. Substantial evidence “is ‘more than
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a mere scintilla’” but it “means only[] ‘such relevant evidence as a reasonable
mind might 	accept 	as 	adequate 	to 	support 	a 	conclusion.’” 	Id. 	(citations
omitted). The Commissioner’s “findings … as to any fact if supported by
substantial evidence [are] conclusive.” 42 U.S.C. § 405(g); Biestek, 587 U.S. at
99.
A court may “not try the case de novo, resolve conflicts in evidence, or
decide questions of credibility.” Bass v. McMahon, 499 F.3d 506, 509 (6th Cir.
2007). Even if substantial evidence or a preponderance of the evidence
supports 	a 	claimant’s 	position, 	a 	reviewing 	court 	cannot 	overturn 	the
Commissioner’s decision “so long as substantial evidence also supports the
conclusion reached by the ALJ.” Jones v. Comm’r of Soc. Sec., 336 F.3d 469,
477 (6th Cir. 2003). This is so because there is a “zone of choice within which”
the Commissioner can act, without fear of judicial “interference.” Lindsley v.
Comm’r of Soc. Sec., 560 F.3d 601, 605 (6th Cir. 2009) (quoting Felisky v.
Bowen, 35 F.3d 1027, 1035 (6th Cir. 1994)).
Discussion
As an initial issue, Hamm has chosen an approach to briefing that is
generally discouraged and specifically contrary to the Court’s initial order.
Hamm has listed just one issue presented but raised at least four separate
issues that are not clearly contemplated in her sole issue statement. See Doc.
4, at 4.
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Setting 	this 	problem 	aside, 	it 	appears 	that 	each of 	Hamm’s sub-
arguments are covered by one umbrella argument in which Hamm challenges
the ALJ’s evaluation of Dr. Chang’s medical opinion. See Doc. 9, at 11
(introducing Hamm’s argument section by generally citing the requirements
for an ALJ’s evaluation of medical opinion evidence). But, as the following
demonstrates, the ALJ properly evaluated, and rejected as unpersuasive, Dr.
Chang’s opinion. So for that reason, and the other reasons explained, each of
Hamm’s arguments fail.
First up is Hamm’s overarching argument that the ALJ failed to
properly consider the persuasiveness of Dr. Chang’s opinion.
The Commissioner is required to evaluate the persuasiveness of all
medical 	opinions 	using 	the 	following 	factors: 	supportability; 	consistency;
treatment relationship, including the length, frequency, purpose, and extent;
specialization; and other factors. 20 C.F.R. §§ 416.920c(a), 416.920c(c)(1)–(5).
Supportability and consistency are the most important factors. 20 C.F.R. §
416.920c(a). Supportability means that “[t]he more relevant the objective
medical evidence and supporting explanations presented by a medical source
are to support his or her medical opinion[] … the more persuasive the medical
opinions … will be.” 20 C.F.R. § 416.920c(c)(1). Consistency means “[t]he more
consistent a medical opinion[] … is with the evidence from other medical
sources and nonmedical sources in the claim, the more persuasive the medical
opinion[] … will be.” 20 C.F.R. § 416.920c(c)(2). The Commissioner must
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explain the supportability and consistency factors when discussing a medical
opinion. 20 C.F.R. § 416.920c(b)(2). “[A]n ALJ need not,” however, “specifically
use the terms ‘supportability’ or ‘consistency’ in his analysis.” Cormany v.
Kijakazi, No. 5:21-cv-933, 2022 WL 4115232, at *3 (N.D. Ohio Sept. 9, 2022)
(citing cases). The Commissioner is not required to discuss the remaining
factors. Id. “A reviewing court evaluates whether the ALJ properly considered
the factors as set forth in the regulations to determine the persuasiveness of a
medical opinion.” Toennies v. Comm’r of Soc. Sec., 2020 WL 2841379, at *14
(N.D. Ohio June 1, 2020) (internal quotation marks and citation omitted).
Here, Hamm argues that the ALJ failed to adequately explain both the
supportability and the consistency of Dr. Chang’s opinions. See Doc. 9, at 13
(asserting that the “ALJ erred under the supportability factor”); id. at 14
(arguing that “even if the ALJ did correctly evaluate Dr. Chang’s opinion under
the supportability factor, the ALJ failed to provide any meaningful analysis
under the consistency factor.”).
When he evaluated Dr. Chang’s opinion, the ALJ stated that “Dr.
Chang’s 	opinion 	is 	not 	persuasive 	or 	consistent 	with 	his 	own 	physical
examinations or the record as a whole.” Tr. 31. The ALJ then provided several
reasons to support that statement. For instance, the ALJ noted that Dr. Chang
“offers no objective evidence in support of extreme absenteeism, rests every 15
minutes (or offer how long each rest would be), support for the continuous
interference and concentration as well as the inability to squat or craw.” Id.
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Additionally, the ALJ recognized that Dr. Chang prescribed a cane and that
physical examinations since the cane was prescribed indicated Hamm used the
cane. See Tr. 31. The ALJ identified, however, that those same physical
examinations showed that Hamm had normal motor strength and tone, no
swelling, and “routinely” unlabored respiratory effort with no wheezing. Id.
The 	ALJ 	then 	concluded 	that 	“Dr. 	Chang’s 	opinion 	offers 	limitations
amounting to less than sedentary work without offering objective evidence in
support.” Id.
The ALJ’s description of the lack of citation or explanation provided by
Dr. Chang to support his opinion corresponds to the mandatory factor of
supportability. 20 C.F.R. § 416.920c(c)(1). And the ALJ’s references to a lack of
support from “the record as a whole” goes to the consistency factor. 20 C.F.R. §
416.920c(c)(2). Importantly, the fact that the ALJ didn’t use certain words,
assuming it can even be said that the ALJ failed to do this, does not mean that
the ALJ erred. Cormany, 2022 WL 4115232, at *3 (citing cases). The ALJ
discussed both the absence of citation to any evidence in Dr. Chang’s opinion,
i.e. supportability, and the existence of record evidence that supported less
restrictive 	limitations, 	i.e. 	consistency. 	So 	the 	ALJ 	complied 	with 	the
applicable regulations by discussing the two mandatory factors that must be
considered when evaluating the persuasiveness of Dr. Chang’s opinion.
Moreover, the ALJ pointed to records found elsewhere in the opinion
when he explained that “the record as a whole do[es] not support [the] assessed
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limitations.” 	Tr. 	32. 	Importantly, 	the 	ALJ’s 	decision 	includes 	detailed
evaluation of the record as a whole including discussion of medical records from
Dr. 	Chang 	and 	other 	practitioners. 	See 	Tr. 	26–29 	(discussing 	Hamm’s
treatment records for both mental and physical conditions). The fact that the
ALJ did not repeat or specifically cite to contrasting medical records when
evaluating Dr. Chang’s opinion, and instead more generally referenced the
record as a whole, is sufficient because the ALJ’s decision is to be read as a
whole. See, e.g., Chicora v. Comm’r of Soc. Sec., 852 F. App’x 968, 970 (6th Cir.
2021) 	(the 	ALJ’s 	brief 	explanation 	discounting 	a 	medical 	opinion, 	in
conjunction with the ALJ’s discussion of the doctor’s treatment notes and exam
findings elsewhere in the decision, satisfied the articulation requirement for
opinion evidence); Crum v. Comm’r of Soc. Sec., 660 F. App’x 449, 457 (6th Cir.
2016) (same); Kraig v. Kijakazi, No. 1:21-cv-1253, 2022 WL 4232692, at *9
(N.D. Ohio Sept. 14, 2022) (ALJ’s evaluation of opinion evidence read “in the
context 	of 	the 	decision 	as 	a 	whole” 	contained sufficient 	articulation 	for
discounting 	the 	opinion) 	(collecting 	cases). 	And, 	as 	indicated, 	the 	ALJ’s
decision includes a detailed discussion of the record, albeit located elsewhere
in his decision. See e.g., Tr. 26–29.
Second, Hamm asserts that “the ALJ’s conclusory and insufficient
analysis is not harmless given that the record contains findings from other
providers consistent with Dr. Chang’s opinion that [Hamm] had exertional and
nonexertional limitations resulting from her spinal impairments and joint
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pain.” Doc. 9, at 6. The primary problem with this argument is that, as the ALJ
recognized, Dr. Chang’s opinion did not provide any citation to this allegedly
consistent other evidence. Tr. 31 (noting that Dr. Chang provided “no objective
evidence in support” of the limitations and that Dr. Chang’s opinion was made
“without offering objective evidence in support”). So Hamm’s citation to
evidence that was not cited in Dr. Chang’s opinion or the ALJ’s discussion of
that opinion, see Doc. 9, at 16–18, but that she apparently believes is consistent
with 	Dr. 	Chang’s 	opinion, 	amounts 	to 	nothing 	more 	than 	her 	own
interpretation of the evidence and speculation that substantial evidence could
support a different outcome. Importantly, Hamm’s burden is not to show that
substantial evidence could support a different outcome. See Jones, 336 F.3d at
477 (explaining that the ALJ’s decision should be upheld even if substantial
evidence or a preponderance of evidence could support a claimant’s position).
Rather, Hamm must show that substantial evidence does not support the
ALJ’s conclusion. Id., see also Biestek, 587 U.S. at 103. She has not done so.
Third, Hamm argues that “Dr. Chang was the only medical professional
providing an opinion regarding [her] need for a cane, and the ALJ failed to
identify substantial evidence supporting the RFC finding.” Doc. 9, at 18. To
find that a “hand-held assistive device is medically required, there must be
medical documentation establishing the need for a hand-held assistive device
to aid in walking or standing, and describing the circumstances for which it is
needed.” SSR 96-9p, 1996 WL 374185, at *7 (emphasis added). To show that an
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assistive device must have been required, a claimant “must also show that his
medical records specifically document the circumstances in which he required
an assistive device—i.e., whether he required one at all times, during all
activities, and on all terrains.” Barnes v. Comm’r of Soc. Sec., No. 5:21-cv-1688,
2023 WL 2988346, at *8 (N.D. Ohio Mar. 22, 2023) (emphasis added); see SSR
96-9p, 1996 WL 374185, at *7.
Hamm’s third argument is confounding for at least three reasons. First,
Hamm highlights that “Dr. Chang was the only medical professional providing
an opinion regarding [her] need for a cane.” Id. But this point detracts from
her argument that the ALJ erred in evaluating Dr. Chang’s opinion. Moreover,
neither 	Dr. 	Chang’s 	checkbox 	opinion, 	nor 	any 	other 	medical 	opinion,
specifically described the circumstances in which Hamm needed a cane. See
SSR 96-9p, 1996 WL 374185, at *7, see also Tr. 3932. Second, the ALJ explicitly
found that Dr. Chang’s opinion was unpersuasive. Tr. 31–32. And Hamm
points to nothing that would require that an ALJ include limitations contained
in an unpersuasive medical opinion into the RFC determination. Third, the
ALJ did include a limitation for a cane in Hamm’s RFC. See Tr. 24 (providing
that Hamm “must be allowed to use a cane for ambulation”).
In connection with this third sub-argument, Hamm also asserts that the
lack of record evidence showing she used her cane exclusively for ambulation
or that she didn’t need her cane for other activities, such as going to the gym,
shows that the ALJ’s decision is not supported by substantial evidence. See
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Doc. 9, at 19. Essentially, Hamm is proposing that the ALJ’s finding that she
needed to use a cane when walking is flawed because there is no evidence that
didn’t use the cane at other times. But Hamm does not attempt to provide any
evidence that she used her cane when standing still or at the gym. See id. And
the evidence that Hamm cites to show that she experienced injury when not
using her cane to walk only illustrates why the ALJ did find she needed her
cane for ambulation. See id. So the ALJ’s decision to provide a limitation for
use of a cane when ambulating is entirely supported by the record and Hamm’s
argument demonstrates as much.
Fourth, Hamm makes several arguments in the final pages of her brief
challenging as “conclusory” the ALJ’s rejection of nonexertional limitations. Tr.
20–22. 	But 	the 	ALJ 	explained 	that 	he 	rejected 	many 	of 	the 	opined
nonexertional limitations because Dr. Chang “offer[d] no objective evidence in
support of extreme absenteeism, rests every 15 minutes (or [] how long ach rest
would 	be), 	support 	for 	the 	continuous 	interference 	with 	attention 	and
concentration as well as the inability to squat or crawl.” Tr. 31 (also stating
that “Dr. Chang’s opinion offers limitations amounting to less than sedentary
work without offering objective evidence in support.”). This is not a conclusory
explanation. To the contrary the ALJ expressly explained what was lacking in
Dr. Chang’s opinion.
Additionally, the Commissioner points out that Dr. Chang’s opinion is a
check-box opinion. Doc. 11, at 5–6. In her reply brief, Hamm argues that the
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ALJ “did not mention the format of [Dr. Chang’s]. Doc. 12, at 2. While the ALJ
did not use the label “check-box opinion,” he did call it a “questionnaire” and
repeatedly noted that the opinion contained no citations to objective evidence.
Tr. 31. Review of the face of Dr. Chang’ opinion likewise reveals that it was a
check-box opinion. See Tr. 3899. So, in addition to the specific deficiencies that
the ALJ identified, Tr. 31, the format of Dr. Chang’s opinion makes it “patently
deficient.” See Dollinger v. Comm’r of Soc. Sec., No. 22-3359, 2023 WL 1777386,
at *4 (6th Cir. Feb. 6, 2023) (a checkbox form completed by a treating source
which only contained a brief explanatory note for the assessed limitations “is
the kind of ‘vague and unhelpful’ opinion that is patently deficient and could
not have been credited by the Commissioner”) (quoting Price v. Comm’r Soc.
Sec. Admin., 342 F. App’x 172, 176 (6th Cir. 2009) (doctor’s reference to
“testing” to support his conclusions on a questionnaire were “vague and
unhelpful” 	and 	did 	not 	provide 	substantial 	evidence 	to 	support 	his
conclusions)).
As Hamm highlights early on in her brief: “The more relevant the
objective medical evidence and supportive explanations presented by a medical
source are to support … [his] … medical opinions … , the more persuasive the
medical opinions … will be.” Doc. 9, at 13 (emphasis added) (citing Goodman
v. Soc. Sec. Admin., 2024 WL 623894, *14 (N.D. Ohio Feb. 14, 2024), in turn
quoting 20 C.F.R. § 416.920c(c)(1)). The ALJ considered the “objective medical
evidence 	and 	supportive 	explanations 	presented” 	in 	Dr. 	Chang’s
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“questionnaire” and found that there was neither objective medical evidence
nor supportive explanations in Dr. Chang’s questionnaire.
In sum, none of Hamm’s arguments, all of which relate to the ALJ’s
evaluation of Dr. Chang’s opinion, and the limitations contained therein, do
not provide a basis for remand.
Conclusion
For the reasons explained above, I recommend that the Court affirm the
Commissioner’s decision.
Dated: November 14, 2025
/s/ James E. Grimes Jr.
James E. Grimes Jr.
U.S. Magistrate Judge
OBJECTIONS
Any objections to this Report and Recommendation must be filed with
the Clerk of Court within 14 days after the party objecting has been served
with a copy of this Report and Recommendation. 28 U.S.C. § 636(b)(1). Failure
to file objections within the specified time may forfeit the right to appeal the
District Court’s order. See Berkshire v. Beauvais, 928 F.3d 520, 530–531 (6th
Cir. 2019).
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