Case Name in Social Security Case - Unavailable

IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF PENNSYLVANIA
JENNIFER SKINNER, 	: Civ. No. 1:24-CV-1725
:
Plaintiff, 	:
:
v. 	:
: (Chief Magistrate Judge Bloom)
FRANK BISIGNANO, 	:
Commissioner of Social Security, 	:
:
Defendant. 	:
MEMORANDUM OPINION
I. 	Introduction
Jennifer Skinner filed a Title II application for a period of disability
and disability insurance benefits on December 23, 2021.1 	Following an
initial hearing before an Administrative Law Judge (“ALJ”), the ALJ
found that Skinner was not disabled from her alleged onset date of
disability of December 22, 2021, through November 16, 2023, the date of
the ALJ’s decision.2
Skinner now appeals this decision, arguing that the ALJ’s decision
is not supported by substantial evidence. 	After a review of the record,
1 Tr. 15.
2 Tr. 15-30.
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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,’”3 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.
II. 	Statement of Facts and of the Case
On December 23, 2021, Skinner applied for disability insurance
benefits, citing an array of physical impairments, including Turner
syndrome, type one diabetes, thyroid disease, and high blood pressure. 4
Skinner was 43 years old at the time of the alleged onset of disability,
had at least a high school education, and had past employment as a
cashier. 5
With respect to these alleged impairments the record revealed the
following: 	The 	earliest 	relevant 	records 	are 	from 	Skinner’s 	virtual
outpatient visit with Dr. David Macaluso in March of 2021 for an
3
Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019).
4 Tr. 200.
5 Tr. 36-69.
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endocrinology follow-up appointment. 6 	She explained to Dr. Macaluso
her impairments of and medications for type one diabetes mellitus,
Turner syndrome, vitamin D deficiency, osteomalacia, osteopenia, and
hypothyroidism. 7
In June of 2021, Skinner presented to the emergency department
after a syncopal episode at work. 	Skinner reported feeling very tired
when she woke up.8 	She received a differential diagnosis of syncope,
dehydration, hypoglycemia, and cardiac arrhythmia. 9 	Skinner again
presented to the emergency department in October of 2021 following
another 	syncopal 	episode 	at 	work. 10 	That 	same 	month, 	Skinner
underwent a tilt table evaluation that indicated symptoms consistent
with orthostatic hypotension with provoked syncope after nitroglycerin. 11
6 Tr. 326-28.
7
Id.
8 Tr. 357-62.
9 Tr. 361.
10 Tr. 448.
11 Tr. 446-47
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Skinner experienced another syncopal episode in December of 2021 while
at work, which caused her to fall and sustain a fractured nose.12
In January of 2022, Skinner appeared for a neurology outpatient
consultation with Dr. Muhamad Salman Siddiqi for further assessment
of her reoccurring syncopal episodes.13 	Dr. Siddiqi ordered a brain MRI,
a head and neck CT, and a EEG.14 	The EEG returned abnormal results
and showed “infrequent left temporal sharp waves with propencity to
develop seizures.”15 	As a result, Skinner was placed on antiepileptic
medication. 16 	The MRI revealed small enhancing heterogeneous lesions
on the left side calvarium. 17 Skinner was referred to Dr. Gregory Arnone
for a neurosurgery consultation. 18 	During her consultation with Dr.
Arnone, Skinner reported feeling normal with the exception of her
12 Tr. 430-35.
13 Tr. 419-24.
14 Tr. 424.
15 Tr. 418-19.
16 Tr. 419.
17 Tr. 417.
18
Id.
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syncopal episodes.19 Dr. Arnone reviewed Skinner’s imaging and noted a
lack of concern over the appearance of the lesions.20 He ordered a nuclear
med bone scan to assess for any further lesions, which showed uptake in
the left parietal lesion and three additional lesions in the skull and an
additional lesion in the ribs.21
In August of 2022, Skinner appeared for a neurology visit with
Certified Physician Assistant (“PA-C”) John Dinma Chukwudifu Jr. 22
Skinner reported that a syncopal episode occurred a week prior with a
15-minute 	postictal. 23 	PA-C 	Chukwudifu 	increased 	Skinner’s
antiepileptic medication and ordered an Magnetic Resonance Angiogram
(“MRA”) of the head and neck.24 	Around this time, Skinner received a
brain MRI, which showed,
inter alia, a small area stroke in the left
19 Tr. 411.
20 Tr. 414.
21 Tr. 407, 414.
22 Tr. 759.
23
Id.
24 Tr. 762.
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parietal region. 25 	Skinner’s head MRA reported 60-70% carotid stenosis
on the right and intracranial atherosclerotic disease which is mild. 26
In September of 2022, Skinner was transported to the emergency
department following a seizure. 27 	Skinner’s mother reported that the
seizure lasted about one minute.28 	Skinner was discharged with a
diagnosis of generalized epilepsy and instructed to follow up with her
neurologist.29 	During a follow-up visit with PA-C Chukwudifu in May of
2023, Skinner reported a syncopal episode occurred a month prior to the
visit. 30
It is against this factual backdrop that the ALJ conducted a hearing
in Skinner’s case on September 29, 2023.31 	Skinner, her mother, and a
vocational expert (“VE”) each testified at this hearing. Skinner testified
about her treatment, the varying nature of her syncopal episodes, her
25 Tr. 755, 757.
26 Tr. 750.
27 Tr. 741.
28 Tr. 742.
29 Tr. 744.
30 Tr. 1025-26.
31 Tr. 36-69.
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difficulties balancing and lifting things, her inability to handle loud
music or vibrations, and her activities of daily living. 32 Skinner’s mother
testified about her observations of Skinner when a syncopal episode
occurs. 33 	The VE in her testimony first classified Skinner’s past work,
then answered hypothetical questions about an individual with Skinner’s
background and specific types of limitations. 34 	On November 9, 2023,
Skinner’s counsel informed the ALJ that she experienced another seizure
the day prior to the hearing.35
Following this hearing, on November 16, 2023, the ALJ issued a
decision denying Skinner’s application for benefits. 36 	In that decision,
the ALJ first concluded that Skinner met the insured status requirement
through December 31, 2025. 37 	At Step 2 of the sequential analysis that
governs Social Security cases, the ALJ found Skinner suffered from the
32 Tr. 42-68.
33 Tr. 58-63.
34 Tr. 63-68.
35 Tr. 316.
36 Tr. 15-30.
37 Tr. 17.
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following severe impairments: seizure disorder, syncope, orthostatic,
hypertension, brain lesions, Turner syndrome, and diabetes Type One. 38
At Step 3 the ALJ determined that Skinner did not have an impairment
or combination of impairments that met or medically equaled the severity
of one of the listed impairments.39
Between Steps 3 and 4 the ALJ concluded that Skinner retained
the following residual functional capacity to:
[P]erform light work as defined in 20 CFR 404.1567(b) subject
to the following: never climb ladders, ropes, or scaffolds, work
at unprotected heights, contact moving mechanical parts, or
operate a motor vehicle; can frequently climb ramps or stairs
or balance; can tolerate occasional exposure to temperature
extremes, humidity, wetness, vibration, or concentrated dust,
fumes, or gases; requires a no loud noise work environment;
a[n]d can maintain concentration, persistence, and pace for
two hour segments sufficient to perform routine two to three
step tasks or instructions. 40
In reaching this RFC determination, the ALJ made the following
findings: the ALJ considered Skinner’s reported, subjective symptoms,
and found that “claimant’s medically determinable impairments could
38 Tr. 17-19.
39 Tr. 20-21.
40 Tr. 21-28.
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reasonably be expected to cause some of 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[.]”41 	The ALJ then
embarked on a lengthy review of the medical record evidence he found
supported those findings. 42
The ALJ then found at Step 4 that Skinner 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 router, marker, and collator operator. 43 	Having reached these
conclusions, 	the 	ALJ 	determined 	that 	Skinner 	had 	not 	met 	the
demanding showing necessary to sustain this claim for benefits and
denied this claim.
This 	appeal 	followed. 44 	On 	appeal, 	Skinner 	challenges 	the
adequacy of the ALJ’s decision arguing it is not supported by substantial
41 Tr. 22.
42 Tr. 22-28.
43 Tr. 28-29.
44 Doc. 1.
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evidence. 45 	As discussed in greater detail below, having considered the
arguments of counsel and carefully reviewed 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.46 	Substantial
evidence “does not mean a large or considerable amount of evidence, but
rather such relevant evidence as a reasonable mind might accept as
adequate to support a conclusion.” 47 	Substantial evidence means less
than a preponderance of the evidence but more than a mere scintilla.48
A single piece of evidence is not substantial evidence if the ALJ
“ignores, 	or 	fails 	to 	resolve, 	a 	conflict 	created 	by 	countervailing
45 Doc. 14.
46
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).
47
Pierce v. Underwood, 487 U.S. 552, 565 (1988).
48
Richardson v. Perales, 402 U.S. 389, 401 (1971).
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evidence.”49 	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.” 50 	The court must “scrutinize
the record as a whole” to determine if the decision is supported by
substantial evidence. 51
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
support a conclusion.’”52 	Under this standard, we must look to the
existing 	administrative 	record 	to 	determine 	if 	there 	is 	“‘sufficient
49
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).
50
Consolo v. Fed. Maritime Comm’n, 383 U.S. 607, 620 (1966).
51
Leslie v. Barnhart, 304 F. Supp. 2d 623, 627 (M.D. Pa. 2003).
52
Biestek, 139 S. Ct. at 1154 (quoting
Consolidated Edison Co. v. NLRB,
305 U.S. 197, 229 (1938)).
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evidence’ to support the agency’s factual determinations.”53 	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. 54
When conducting this review, we must remain mindful that “we
must not substitute our own judgment for that of the fact finder.” 55 Thus,
we cannot re-weigh the evidence. Instead, we must determine whether
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
53
Id.
54
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 . . . .”).
55
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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articulate the reasons for his decision.56 	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. 57 	Ultimately, 	the 	ALJ’s 	decision 	must 	be
accompanied by “a clear and satisfactory explication of the basis on which
it rests.” 58
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
than 12 months.” 59 This requires a claimant to show a severe physical or
56
Burnett v. Comm’r of Soc. Sec. Admin., 220 F.3d 112, 119 (3d Cir. 2000).
57
See Diaz v. Comm’r of Soc. Sec., 577 F.3d 500, 504 (3d Cir. 2009)
(citations omitted).
58
Cotter v. Harris, 642 F.2d 700, 704 (3d Cir. 1981).
59 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).
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mental impairment that precludes him or her from engaging in previous
work or “any other substantial gainful work which exists in the national
economy.” 60 	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. 61
In 	making 	this 	determination, 	the 	ALJ 	follows 	a 	five-step
evaluation. 62 	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”).63
60 	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).
61 42 U.S.C. §423(a); 20 C.F.R. §404.131(a).
62 20 C.F.R. §§404.1520(a), 416.920(a).
6320 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).”64 	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. 65 	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. 66
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. 67 	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
64
	Burnett, 220 F.3d at 121 (citations omitted);
	see also 20 C.F.R. §
404.1545(a)(1).
65 20 C.F.R. §§404.1545(a)(2), 416.945(a)(2).
66
Burns v. Barnhart, 312 F.3d 113, 129 (3d Cir. 2002).
67
Mason, 994 F.2d at 1064.
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consistent 	with 	the 	claimant’s 	RFC, 	age, 	education, 	and 	work
experience. 68
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.” 69 	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.” 70
Given these differing approaches, we must evaluate the factual
context 	underlying 	an 	ALJ’s 	decision. 	Cases 	that 	emphasize 	the
68 20 C.F.R. §§404.1512(f), 416.912(f);
Mason, 994 F.2d at 1064.
69
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).
70
Cummings v. Colvin, 129 F. Supp. 3d 209, 214–15 (W.D. Pa. 2015).
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importance of medical opinion support for an RFC assessment typically
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. 71 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. 72 	Ultimately, it is our task to determine,
considering 	the 	entire 	record, 	whether 	the 	RFC 	determination 	is
supported by substantial evidence. 73
71
Biller, 962 F. Supp. 2d at 778–79.
72
See Titterington, 174 F. App’x 6;
Cummings, 129 F. Supp. 3d at 214–
15.
73
Burns, 312 F.3d 113.
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C. Legal Benchmarks for the ALJ’s Assessment of a Claimant’s
Alleged Symptoms
For applications filed after March of 2017, the regulations require
ALJs 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. 74 	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.75 	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.” 76 	The consistency
factor focuses on how consistent the opinion is “with the evidence from
other medical sources and nonmedical sources.”77
74 20 C.F.R. § 404.1520c(c).
75 20 C.F.R. §§ 404.1520c(b)(2), 416.920c(b)(2);
Blackman v. Kijakazi, 615
F. Supp. 3d 308, 316 (E.D. Pa. 2022).
76 20 C.F.R. §§ 404.1520c(c)(1), 416.920c(c)(1).
77 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.” 78 	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.” 79 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.80 	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.” 81
78
Chandler v. Comm’r of Soc. Sec., 667 F.3d 356, 361 (3d Cir. 2011).
79
Mason, 994 F.2d at 1066.
80
See Durden v. Colvin, 191 F. Supp. 3d 429, 455 (M.D. Pa. 2016).
81
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.’” 82 	Judged against this deferential
standard of review, we conclude that substantial evidence supported the
ALJ’s decision in this case.
Skinner first argues that the ALJ failed to identify a significant
number of jobs that she can perform. 83 The ALJ found that Skinner could
perform three occupations: marker (DOT 209.587-034, 1991 WL 671802),
router (DOT 222.587-038, 1991 WL 672123), and collator operator (DOT
208.685-010, 1991 WL 671753).84 	Skinner claims the jobs of a marker
and router are outdated and obsolete, and the functions of a collator
82
Biestek, 139 S. Ct. at 1154.
83 Doc. 14 at 9-13.
84 Tr. 29.
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operator directly conflict with the ALJ’s finding that she refrain from
moving mechanical parts. 85
Specifically, Skinner argues that 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”).86 However, courts in our circuit “have been hesitant to reject
the testimony of Vocational Experts relying upon the DOT in favor of the
descriptions 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.’”87 	“[T]he regulations simply do not require a [Vocational
Expert’s] testimony to be consistent with O*Net.”88 	We agree with this
body of caselaw and conclude that the ALJ fulfilled his requirement
under the controlling regulations.
85 Doc. 14 at 11-12.
86
Id. at 9-10.
87
Pollock v. O’Malley, No. 1:22-cv-1856, 2024 WL 4803530, at *19 (M.D.
Pa. Nov. 15, 2024) (collecting cases).
88
Id. at *20.
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As to the job of a router, Skinner relies on
Kelly P. v. Saul 89 in
arguing that the occupation is obsolete due to technological advances of
which 	the 	DOT 	fails 	to 	consider. 	While 	the 	out-of-circuit 	caselaw
recognized 	the 	“possibility 	that 	the 	description 	[of 	a 	router] 	was
outdated,” it also noted that it “is inadequate to find that the occupation
of router, as it is described in the DOT, is completely obsolete.”90 Rather,
it relied on binding precedent to conclude that technological advances
have likely led to a reduction in the number of router jobs and that even
a “modest reduction of [] 28,000 jobs . . . would mean that the number of
available jobs is no longer significant.”91 	However, “there is no precise
estimate for what constitutes ‘significant numbers’ of jobs under the
Social Security Act.”92 	Here, the ALJ identified two other jobs with over
136,000 and 33,000 national positions, respectively. 93 	We find this
89 No. 5:18-cv-777, 2019 WL 3573591, at *5–6 (S.D. Cal. Aug. 6, 2019).
90
Id.
91
Id.
92
Young v. Astrue, 519 F. App’x 769, 772 (3d Cir. 2013).
93 Tr. 65.
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satisfies the Commissioner’s requirement to identify jobs that exist in
significant numbers in the national economy.94
Skinner also relies on the DOT and O*NET in alleging that certain
details of a collator operator are incompatible with her limitation to avoid
work 	around 	“moving 	mechanical 	parts.” 95 	But 	as 	noted 	above,
adherence to the descriptions on O*NET is not required.96 	Additionally,
it is not necessary to look to narrative descriptions in the DOT to
determine if an occupation involved moving mechanical parts, because
the 	DOT 	states 	whether 	any 	occupation 	therein 	involves 	moving
mechanical parts. 	The DOT is unambiguous that the occupation of
collator operator does not involve moving mechanical parts.97 	Skinner’s
argument is therefore without factual support and so is unavailing.
94
See Young, 519 F. App’x at 772 (finding that 20,000 available jobs
sufficient to establish work exists in significant numbers).
95 Doc. 14 at 11-12.
96
Pollock, 2024 WL 4803530, at *20.
97
See 1991 WL 671753.
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Skinner’s second contention is that the ALJ erred in failing to
address her need to lie down and nap during the day.98 	While Skinner
argues that the ALJ did not consider this evidence, the ALJ did note
Skinner’s testimony of her tiredness and need to rest at times during the
day when discussing her symptoms, as well as the medical evidence
showing that Skinner denied experiencing fatigue during the relevant
period. 99 	Ultimately, the ALJ determined that Skinner was not as
limited as she alleged because her allegations were not entirely credible
or supported by the objective medical evidence. 	Thus, while Skinner
contends that the ALJ failed to include a limitation to account for her
need to nap, the ALJ need only include a claimant’s credibly established
limitations in the RFC. 100 	Accordingly, we conclude that the ALJ’s RFC
determination is supported by substantial evidence.
Finally, Skinner argues the ALJ made errors in evaluating her
reported symptoms. 101 	Skinner alleges the ALJ improperly noted she
98 Doc. 14 at 13-14.
99 Tr. 21-23.
100
See Rutherford, 399 F.3d at 554.
101 Doc. 14 at 14-17.
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was in no acute distress during medical visits, failed to provide sufficient
reasoning in finding that her statements were inconsistent with the
medical evidence, and failed to consider her consistent work history.
Skinner’s argument that the ALJ improperly noted that she was
not in acute distress at her medical visits is unavailing. Indeed, the ALJ
did report several instances in which the medical record noted Skinner
to be in “no acute distress,”102 	but there is nothing in the decision
suggesting 	the 	ALJ 	improperly 	interpreted 	that 	evidence. 	It 	is
indisputable that the notes in the medical record of “no acute distress”
are merely listed in the ALJ’s decision as being contained in the medical
record. 103 Skinner seemingly believes the ALJ’s references to these notes
somehow show he improperly made further inferences, but she does not
explain what inferences the ALJ made, where such inferences are located
in the text of the decision, nor why such inferences are inappropriate, and
so this argument fails.
102 Tr. 23.
103
See id.
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As to the argument that the ALJ found Skinner’s alleged symptoms
to 	be 	inconsistent 	with 	the 	objective 	medical 	evidence 	without
explanation, we discern no error in the ALJ’s evaluation. 	The ALJ did
not simply make such a conclusion without proper articulation. The ALJ
discussed the evidence at length, including both abnormal and normal
medical findings. 	These findings included,
inter alia, Skinner’s reports
of syncopal episodes and seizures, as well as abnormal medical findings
such as her blood pressure readings, EEG testing, cardiac testing, tilt
table testing, and brain MRI results. 104 	Ultimately, while the ALJ
acknowledged the abnormal findings during the relevant time, the ALJ
explained that the record as a whole did not demonstrate that Skinner
was as limited as she alleged.105 	Accordingly, we find the ALJ’s finding
of Skinner’s allegations to be supported by substantial evidence.
Lastly, Skinner argues the ALJ erred in failing to consider her
consistent work history because it constituted favorable evidence that
required consideration. We find this claim is without merit. Indeed, the
104 Tr. 22.
105 Tr. 22-28.
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ALJ referenced Skinner’s work history as a cashier in his decision and
considered a report completed by her former employer. 106 	In reading the
decision as a whole,107 we find that the ALJ simply found that Skinner’s
work history did not outweigh the objective medical evidence. In any
event, Skinner also fails to identify how prejudice inured from such
alleged error. 	Social Security appeals are subject to harmless error
analysis. 108 	Under the harmless error analysis, a remand is warranted
only if the error “prejudices a party’s ‘substantial rights’”; that is, if the
error “likely affects the outcome of the proceeding, . . .”109 	Skinner’s
argument fails to demonstrate prejudice occurred, and so, even assuming
arguendo that it was an error, we hold now it was harmless.
Accordingly, under the deferential standard of review that applies
to appeals of Social Security disability determinations, we conclude that
106 Tr. 27-28
107
Leslie, 304 F. Supp. 2d at 627.
108
See Holloman v. Comm’r Soc. Sec., 639 F. App’x 810, 814 (3d Cir.
2016).
109
Hyer v. Colvin, 72 F. Supp. 3d 479, 494 (D. Del. 2014).
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substantial evidence supported the ALJ’s evaluation of this case, and this
decision should be affirmed.
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 20th day of January 2026.
s/ Daryl F. Bloom
Daryl F. Bloom
Chief United States Magistrate Judge
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