Opinion
EP-22-CV-00407-KC-RFC
06-13-2023
LYDIA CHAVARRIA, Plaintiff, v. DR. KILOLO KIJAKAZI, Acting Commissioner of the Social Security Administration, Defendant. .
REPORT AND RECOMMENDATION
ROBERT F. CASTANEDA UNITED STATES MAGISTRATE JUDGE
Plaintiff Lydia Chavarria appeals from the decision of the Commissioner of the Social Security Administration, denying her claim for disability insurance benefits (“DIB”) under Title II of the Social Security Act. For the following reasons, the Court recommends that the Commissioner's decision be AFFIRMED.
I. PROCEDURAL HISTORY
On October 9, 2020, Chavarria filed a DIB application alleging disability beginning on March 17, 2020, due to disorders of the back, peripheral neuropathy, extreme high blood pressure, dizziness, diabetes, high cholesterol, anemia, anxiety, frequent urination, dry mouth, severe headaches, and blurry vision. (R:83, 85.)
Chavarria's application was initially denied on or about February 23, 2021 (R:83-96) and again upon reconsideration on or about June 8, 2021 (R:97-113). See also (R:35.) On February 9, 2022, Administrative Law Judge (“ALJ”) Ilene Kramer conducted a hearing. (R:49-82.) On March 28, 2022, the ALJ issued an unfavorable decision. (R:32-48.) The Appeals Council denied Chavarria's request for review on August 31, 2022. (R:7-13.) Thus, the ALJ's decision became the Commissioner's final decision in Chavarria's case. (R:7.)
The hearing was held telephonically due to the COVID-19 pandemic. (R:51-52.)
II. DISCUSSION
A. Standard of Review
Judicial review of the Commissioner's decision is limited to a determination of whether (1) the Commissioner's final decision is supported by substantial evidence on the record and (2) the Commissioner applied the proper legal standards. See 42 U.S.C. § 405(g); Copeland v. Colvin, 771 F.3d 920, 923 (5th Cir. 2014).
Substantial evidence is more than a scintilla but less than a preponderance and is “sufficient for a reasonable mind to accept as adequate to support a conclusion.” Spellman v. Shalala, 1 F.3d 357, 360 (5th Cir. 1993). To determine whether substantial evidence supports the Commissioner's decision, courts weigh “four elements of proof”: “(1) objective medical facts; (2) diagnoses and opinions of treating and examining physicians; (3) the claimant's subjective evidence of pain and disability; and (4) his age, education, and work history.” Martinez v. Chater, 64 F.3d 172, 174 (5th Cir. 1995). A court must “scrutinize the record” but “may not reweigh the evidence, try the issues de novo, or substitute [the court's] judgment for that of the [Commissioner].” Haywood v. Sullivan, 888 F.2d 1463, 1466 (5th Cir. 1989) (per curiam); see also Perez v. Barnhart, 415 F.3d 457, 461 (5th Cir. 2005) (“Conflicts of evidence are for the Commissioner, not the courts, to resolve.”). “A finding of no substantial evidence is appropriate only if no credible evidentiary choices or medical findings support the decision.” Boyd v. Apfel, 239 F.3d 698, 704 (5th Cir. 2001) (internal quotes and citations omitted). If substantial evidence supports the Commissioner's findings, they are conclusive and must be affirmed. Perez, 415 F.3d at 461.
A court's finding of legal error requires either automatic reversal or harmless error analysis, depending on the steps taken by the ALJ to reach the final decision. Keel v. Saul, 986 F.3d 551, 556 (5th Cir. 2021); see infra Section II.B. Broadly, “[h]armless error exists when it is inconceivable that a different administrative conclusion would have been reached even if the ALJ did not err.” Keel, 986 F.3d at 556. Courts apply harmless error analysis “to preserve judgments and avoid waste of time.” Mays v. Bowen, 837 F.2d 1362, 1364 (5th Cir. 1988) (per curiam) (“Procedural perfection in administrative proceedings is not required.”).
B. Evaluation Process
Under the Social Security Act, disability is defined as the “inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment . . . which has lasted or can be expected to last for a continuous period of not less than 12 months.” 42 U.S.C. § 423(d)(1)(A); see 42 U.S.C. § 416(i). An ALJ evaluates disability claims according to a five-step sequential process: (1) whether the claimant is currently engaged in substantial gainful activity; (2) whether the claimant has a severe medically determinable impairment; (3) whether the claimant's impairment meets or medically equals the severity of an impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix 1; (4) whether the impairment prevents the claimant from performing past relevant work; and (5) whether the impairment prevents the claimant from doing any other work. 20 C.F.R. § 404.1520(a)(4).
Between steps three and four, the ALJ determines the claimant's “residual functional capacity” (“RFC”). Id. § 404.1520(e). The RFC “is the most [the claimant] can still do” despite the limitations caused by her physical and mental impairments. Id. § 404.1545(a)(1). The ALJ then considers the RFC to make determinations at steps four and five. Id. § 404.1520(e).
At the first four steps, the claimant bears the burden of proving that she is disabled. Fraga v. Bowen, 810 F.2d 1296, 1301 (5th Cir. 1987). If the claimant meets this burden, at step five the burden shifts to the Commissioner “to show that there is other substantial gainful employment available that the claimant is capable of performing.” Id. at 1301-02. If the Commissioner satisfies this burden, “the burden then shifts back to the claimant to prove that he is unable to perform the alternate work.” Id. at 1302.
C. The ALJ's Findings
In this case, at step one, the ALJ found that Chavarria had not engaged in substantial gainful activity since March 17, 2020, the alleged onset date of disability. (R:37.) At step two, the ALJ determined that Chavarria had a severe impairment of lumbar spine degenerative disc disease, with other non-severe impairments. (R:37-39.) At step three, the ALJ concluded that Chavarria did not have an impairment that met or medically equaled the severity of an impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix 1. (R:39.)
For Chavarria's RFC, the ALJ determined that Chavarria could perform medium work but must avoid work around unprotected heights, dangerous equipment, and “other hazards” due to dizziness. (R:39-43.)
A “medium work” job “involves lifting no more than 50 pounds at a time with frequent lifting or carrying of objects weighing up to 25 pounds.” 20 C.F.R. § 404.1567(c). “If someone can do medium work, [the Commissioner] determine[s] that he or she can also do sedentary and light work.” Id.
At step four, the ALJ found that Chavarria's RFC did not preclude her from performing her past relevant work as a waitress, cashier, counter supervisor, and deli manager. (R:43-44.) Accordingly, the ALJ concluded, Chavarria was not disabled from March 17, 2020, through the date of the ALJ's decision, March 28, 2022. (R:44.)
The ALJ determined that Chavarria would remain insured through December 31, 2024, so for DIB purposes, Chavarria had to establish disability on or before that date. (R:35.)
D. Analysis
1. ALJ's Evaluation of Navarro's Opinion
Chavarria alleges that the ALJ erred by failing to properly evaluate the persuasiveness of the January 12, 2022, medical opinion of Celina Navarro, AGACNP-BC, pursuant to 20 C.F.R. § 404.1520c(b)(2). (ECF No. 8:6, 8-17.)
The ALJ determines the RFC by examining “all of the relevant medical and other evidence.” 20 C.F.R. § 404.1545(a)(3). For claims filed on or after March 27, 2017, the ALJ must articulate the persuasiveness of “medical opinions” and “prior administrative medical findings” when considering such evidence. Id. § 404.1520c(a). Persuasiveness is based on a number of factors that the ALJ must consider, but the ALJ need only articulate “supportability” and “consistency” in her decision. Id. § 404.1520c(b)(2), (c). “Supportability” means that a medical source's opinion is “more persuasive” when it is supported by relevant objective medical evidence and explanations presented by the same medical source. Id. § 404.1520c(c)(1); see Hubbard v. Comm'r of Soc. Sec., No. 4:20-cv-00588-BP, 2022 WL 196297, at *4 (N.D. Tex. Jan. 21, 2022) (“An opinion is unsupported if the physician ‘did not provide a detailed explanation for [the] opinion' or if ‘the physician's own treatment notes do not support the physician's opinion.'” (quoting Starman v. Kijakazi, No. 2:20-cv-00035-SRC, 2021 WL 4459729, at *4 (E.D. Mo. Sept. 29, 2021))). On the other hand, “consistency” means that a medical opinion is “more persuasive” when it coincides “with the evidence from other medical sources and nonmedical sources in the claim.” 20 C.F.R. § 404.1520c(c)(2). In other words, “supportability looks internally to the bases presented by the medical opinion itself” while “consistency is an external inquiry that juxtaposes a medical opinion to other evidence in the record, including opinions of other medical professionals.” Sharon H. v. Kijakazi, No. 5:21-CV-167-H, 2022 WL 3951488, at *3 (N.D. Tex. Aug. 31, 2022).
The ALJ does not need to articulate persuasiveness for statements from nonmedical sources. 20 C.F.R. § 404.1520c(d). Additionally, “[n]ot all statements by medical providers are considered medical opinions.” William T. v. Comm'r of Soc. Sec., No. 6:18-CV-0055-BU, 2020 WL 6946517, at *3 (N.D. Tex. Nov. 25, 2020). “A medical opinion is a statement from a medical source about what [the claimant] can still do despite [her] impairment(s) and whether [she has] one or more impairment-related limitations or restrictions” in the ability to perform physical, mental, or other demands of work, or to adapt to environmental conditions. 20 C.F.R. § 404.1513(a)(2). By contrast, “[o]bjective medical evidence is medical signs, laboratory findings, or both.” Id. § 404.1513(a)(1). And “other medical evidence” includes “judgments about the nature and severity of” the claimant's impairments, her medical history, “clinical findings, diagnosis, treatment prescribed with response, or prognosis.” Id. § 404.1513(a)(3).
Although the 20 C.F.R. § 404.1520c requirements went into effect March 27, 2017, legal authority preceding that date may still be instructive, e.g., as related to the “consistency” and “supportability” of medical opinions. See Garcia v. Saul, No. SA-19-CV-01307-ESC, 2020 WL 7417380, at *4 (W.D. Tex. Dec. 18, 2020).
The ALJ's explanation of persuasiveness must “enable[] the court to undertake a meaningful review of whether his finding with regard to the particular medical opinion was supported by substantial evidence” and must not “require the [c]ourt to merely speculate about the reasons behind the ALJ's persuasiveness finding or lack thereof.” Cooley v. Comm'r of Soc. Sec., 587 F.Supp.3d 489, 499 (S.D.Miss. 2021). “Stated differently, there must be a discernible ‘logic bridge' between the evidence and the ALJ's persuasiveness finding.” Pearson v. Comm'r of Soc. Sec., No. 1:20-CV-166-HSO-RPM, 2021 WL 3708047, at *5 (S.D.Miss. Aug. 11, 2021) (citing Ramirez v. Saul, No. SA-20-CV-00457-ESC, 2021 WL 2269473, at *6 (W.D. Tex. June 3, 2021)), report and recommendation adopted, 2021 WL 3663073 (S.D.Miss. Aug. 18, 2021).
Here, the ALJ treated Navarro's January 12, 2022, opinion as a medical opinion. (R:42-43) (prefacing that she “fully considered the medical opinions and prior administrative medical findings as follows,” and then discussing Navarro's opinion, cited as Exhibit 9F of the administrative record); see (R:403-10) (Exhibit 9F). The parties do not dispute the ALJ's characterization of Navarro's opinion as a medical opinion. See (ECF Nos. 8:5-6; 11:1, 3-4.)
Navarro opined that as of February 23, 2021, Chavarria could, inter alia, occasionally lift up to fifty pounds; frequently lift and carry up to twenty pounds; sit, stand, and walk for four hours each, uninterrupted and total in an eight-hour workday; continuously use each hand; occasionally operate foot controls with each foot; occasionally climb stairs, ramps, ladders, and scaffolds; occasionally balance, stoop, and crawl; and frequently kneel and crouch. (R:403-06, 408.) Navarro also stated that Chavarria has daily vertigo, putting her at risk for falls. (R:404.) For environmental limitations, Navarro noted that Chavarria could never tolerate unprotected heights; occasionally tolerate moving mechanical parts, extreme cold and heat, vibrations, dust, odors, fumes, and pulmonary irritants; occasionally operate a motor vehicle; frequently tolerate humidity and wetness; and tolerate a moderate level of noise. (R:407.) Based on Chavarria's physical impairments, Navarro concluded that Chavarria could not walk a block at a reasonable pace on rough or uneven surfaces but could take care of herself and do other tasks such as climbing steps with a handrail, shopping, traveling alone, using public transportation, and handling files. (R:408.)
The ALJ deemed the limitations noted by Navarro as “suggestive of medium work.” (R:43.) She found that Navarro failed to explain “why there would be difficulty with standing, walking, lifting[,] and carrying,” and that such limitations “were inconsistent with treatment notes at [Exhibit] 11F, which indicated the claimant's physical examination was within normal limits with a normal steady gait and no pain or swelling in the back or joints.” (Id.); see (R:450-93) (Exhibit 11F). She also stated that Navarro's noted “limitations related to vertigo were not defined in frequency, duration[,] or severity.” (R:43.) Based on these conclusions, the ALJ found Navarro's opinion to be “less persuasive.” (Id.)
Chavarria claims that the ALJ did not adequately articulate the “supportability” and “consistency” of Navarro's opinion. (ECF No. 8:8.) She argues that the ALJ failed to address the supportability factor at all. (Id. at 15.) Additionally, she posits that the ALJ's persuasiveness analysis improperly calls for speculation because the ALJ did not state which opinion she found Navarro's to be “less persuasive” than. (Id.) (citing Schwartz v. Kijakazi, No. 4:20-cv-00739, 2021 WL 3620071, at *3 (S.D. Tex. Aug. 16, 2021)).
Chavarria advances additional arguments that require separate discussion. See infra Sections II.D.1.a and II.D.2.
In response, the Commissioner contends that substantial evidence supports the ALJ's “less persuasive” determination of Navarro's opinion. (ECF No. 11:3.) The Commissioner posits that Navarro's “checkbox form” opinion “gave minimal supportive explanation for Plaintiff's limitations.” (Id. at 4.) Further, the Commissioner asserts that “Navarro's own examination notes . . . do not support her opinion” because the notes show that Chavarria “had a normal gait and strength.” (Id.) (citing R:429-30, 442-43). Additionally, the Commissioner references “other examination notes” that were inconsistent with Navarro's opinion because they showed normalcy in Chavarria's gait and strength. (Id.) (citing R:351-52, 461, 468, 474).
In reply, Chavarria reiterates some of her original arguments. (ECF No. 12:2-3.) She also emphasizes that, contrary to the Commissioner's claim, “[t]he ALJ failed to provide any reference to Ms. Navarro's own treatment records” for purposes of the supportability analysis. (Id. at 2.) Thus, Chavarria says, the Commissioner is asking the Court to accept post hoc reasoning for the ALJ's supportability assessment, which the Court cannot do. (Id.) (citing Vinning v. Astrue, No. 4:08-CV-059-A, 2009 WL 920192, at *6 (N.D. Tex. Apr. 2, 2009) and Newton v. Apfel, 209 F.3d 448, 455 (5th Cir. 2000)).
Relevant to the persuasiveness of Navarro's opinion, Exhibit 10F of the administrative record includes treatment notes from Chavarria's visits with Navarro on January 7, 2022 (R:426-31), October 18, 2021 (R:439-45), and February 23, 2021 (R:446-49). Exhibit 10F also includes treatment notes from other medical providers. See, e.g., (R:432-38) (consisting of notes from Dr. Kazue Okajima). Exhibit 11F consists of treatment notes from medical providers other than Navarro. (R:450-93.) Exhibit 12F consists of the magnetic resonance imaging report (“MRI Report”), which was signed by Navarro on February 25, 2022, and contains evaluations by other medical providers. (R:494-98.) The ALJ discusses these exhibits at various points in her decision. The Court considers these discussions as part of the ALJ's persuasiveness analysis, to the extent they are clearly relevant, even if they are written in different sections of the ALJ's decision. See Shelby v. Comm'r of Soc. Sec., No. 9:21-CV-00038-TH, 2022 WL 18356684, at *7 (E.D. Tex. Dec. 15, 2022) (regarding the court's review of the ALJ's consistency assessment, “the undersigned's review extends beyond just the part of the decision directly discussing a specific opinion”), report and recommendation adopted, No. 9:21-CV-38, 2023 WL 219340 (E.D. Tex. Jan. 13, 2023); Clay v. Kijakazi, No. 4:21CV149-SA-DAS, 2022 WL 13989015, at *6 (N.D. Miss. Oct. 21, 2022) (citing Hubbard, 2022 WL 196297) (“[T]he court must consider more than just the part of the decision directly discussing a specific opinion. Other parts of a decision may well add to the explanation.”).
Navarro's treatment notes for the February 23, 2021, visit appear to be incomplete, at least for lack of a signature page. See (R:446-49.)
As mentioned, according to the ALJ, Navarro's opinion on Chavarria's “standing, walking, lifting, carrying[,] and postural limitations” conflicts with other medical providers' findings at Exhibit 11F “which indicated the claimant's physical examination was within normal limits with a normal steady gait and no pain or swelling in the back or joints.” See (R:43.) Elsewhere in the ALJ's decision, the ALJ discussed specific parts of Exhibit 11F relevant to the consistency analysis. (R:41) (noting observations of “no complaints” from Chavarria and her feeling “well with no issues,” “normal gait and station,” “normal musculoskeletal examination with normal tone and normal strength,” and “normal back curvature” from Chavarria's November 1, 2021, appointment at Candelaria Medical Center); see (R:460-61) (relevant treatment notes from Chavarria's November 1, 2021, examination). The Court is able to meaningfully review the ALJ's explanation regarding lack of consistency and finds that it is supported by substantial evidence. See (R:43, 460-61, 468-69, 474-75); Cooley, 587 F.Supp.3d at 499. Because the ALJ sufficiently explains the connection between her consistency determination and the record evidence, her consistency assessment meets the 20 C.F.R. § 404.1520c requirements. Ramirez, 2021 WL 2269473, at *6; cf. Miller v. Kijakazi, No. 22-60541, 2023 WL 234773, at *3 & n.2 (5th Cir. Jan. 18, 2023) (per curiam) (finding that the ALJ failed to provide enough explanation to meet the 20 C.F.R. § 404.1520c requirements).
Turning to the supportability assessment, the ALJ seems to say that Navarro's opinion lacks support because (1) Navarro failed to define vertigo limitations in terms of “frequency, duration[,] or severity” and (2) Navarro failed to explain “why there would be difficulty with standing, walking, lifting[,] and carrying.” (R:43.) Regarding the vertigo issue, the ALJ sufficiently explained her reasoning based on the MRI Report. She acknowledged that the MRI Report revealed “no acute intracranial abnormalities or suspicious enhancement,” “diffuse cerebral volume loss as well as findings suggestive of chronic microvascular ischemic disease,” and “a type II vascular AICA loop noted extending into the right internal auditory canal . . . result[ing] in abutment of the right seventh and eighth cranial nerves.” (R:41) (citing R:494-98). Elsewhere in the opinion, she stated that:
It is unclear to what extent Navarro evaluated the MRI Report. (R:403-10) (providing Navarro's opinion, which lacks specific reference to the MRI Report); (R:495-98) (providing the MRI Report, which lists Navarro as the “provider” and contains her signature but includes evaluations from other medical providers); see also (R:426, 431, 439, 443) (showing mentions of MRI referral in Navarro's notes). Because Navarro signed the MRI Report, the Court considers it to be objective medical evidence “presented by” Navarro for purposes of the supportability assessment. 20 C.F.R. § 404.1520c(c)(1); see, e.g., E. R. N. v. Comm'r of Soc. Sec., No. 21-cv-429, 2022 WL 4295410, at *5 (W.D. La. July 7, 2022) (discussing MRI results as “potentially supportive of” a doctor's opinion where the doctor referred the plaintiff for the MRI), report and recommendation adopted, 2022 WL 4295351 (W.D. La. Sept. 16, 2022).
Vertigo is not a medically determinable diagnosis as the appropriate diagnostic testing, such as caloric or other vestibular tests, has not been documented in this record. There is a recent MRI dated February 2022, that suggests vascular
compression syndrome, but recommends clinical correlation with findings (Ex. 12F/4). While this suggests a possible cause of the dizziness, the record has not been developed yet and claimant has not been prescribed any treatment yet. Other records indicate that dizziness may be caused by stress (Exs. 5F, 11F/13), a psychological component, polypharmacy or vagal component (Ex. 10F/26).(R:38.) She further explained that “[t]he dizziness has been described as worsening and ‘off and on,'” but aside from Chavarria's subjective complaints, “this record does not document the frequency, intensity[,] or severity of the dizziness to a degree that is predicted to preclude all work.” (Id. at 43.) The Court is able to follow the ALJ's reasoning for finding Navarro's vertigo opinion unsupported.
However, the ALJ's supportability assessment is deficient with respect to the other limitations in Navarro's opinion. The Court recognizes that there are baseline persuasiveness issues because Navarro's opinion is a standard form containing minimal explanations for her responses. (R:403-10); see Braley v. Kijakazi, No. 3:20-CV-3207-X-BH, 2022 WL 4280918, at *18 (N.D. Tex. Aug. 31, 2022) (collecting cases regarding form checkbox and fill-in-the-blank reports as “weak” evidence when lacking explanatory notes or additional supporting evidence), report and recommendation adopted, 2022 WL 4280652 (N.D. Tex. Sept. 15, 2022). However, Navarro's more detailed treatment notes were available for the ALJ's review at Exhibit 10F in the record. (R:426-31, 439-49.) In relevant part, the ALJ discussed Exhibit 10F for the medical records from Chavarria's “initial consult” at Texas Tech University on December 20, 2021. (R:41.) But those particular records were taken by Dr. Kazue Okajima, not Navarro. See (R:432-38); 20 C.F.R. § 404.1520c(c)(1). The ALJ did not discuss Navarro's own treatment notes, and thus, she did not explain how those notes failed to support Navarro's opinion. In sum, the ALJ failed to bridge the gap between her supportability determination and Navarro's treatment notes, and without such guidance, the Court is left to speculate why Navarro's records fail to support her opinion. See, e.g., Ramirez, 2021 WL 2269473, at *4-6; Bjorklund v. Kijakazi, No. 4:21-cv-01810, 2022 WL 2392315, at *4-5 & n.1 (S.D. Tex. July 1, 2022), report and recommendation adopted, 2022 WL 2905471 (S.D. Tex. July 22, 2022). Therefore, the ALJ erred by failing to sufficiently articulate the supportability of Navarro's opinion per 20 C.F.R. § 404.1520c. Miller, 2023 WL 234773, at *3 & n.2; Cooley, 587 F.Supp.3d at 499-500.
Cf. Hubbard, 2022 WL 196297, at *4 (deeming sufficient the ALJ's explanation that a doctor's opinion was unsupported because the doctor's opinion was “in questionnaire format” without elaborative explanations and the doctor's treatment notes were “not in the file” for the ALJ's review (emphasis added)).
a. Harmless Error
When the ALJ proceeds past step two and commits error, “remand is warranted only if the ALJ's error was harmful.” Miller, 2023 WL 234773, at *3 (citing Shineski v. Sanders, 556 U.S. 396, 407-08 (2009)); see Keel, 986 F.3d at 556 (discussing automatic reversal versus harmless error analysis). It is the plaintiff's burden to show prejudice or harm from the error. Jones v. Astrue, 691 F.3d 730, 734-35 (5th Cir. 2012).
In an unpublished opinion, the Fifth Circuit recently specified that, to show prejudice from an ALJ's failure to comply with 20 C.F.R. § 404.1520c articulation requirements, the plaintiff must “show that if the ALJ had given further explanation [of the medical opinions at issue], then she would have adopted them.” Miller, 2023 WL 234773, at *4. Otherwise, the plaintiff would “essentially [be] asking [the court] to reweigh the evidence to show that she was prejudiced by the ALJ's failure to explain, which [the court] cannot do.” Id. (citing Garcia v. Berryhill, 880 F.3d 700, 704 (5th Cir. 2018)). The Court reads Miller as a specific application of the broader principle that harmless error “exists when it is inconceivable that a different administrative conclusion would have been reached even if the ALJ did not err.” Keel, 986 F.3d at 556.
Chavarria suggests the possibility that the ALJ was, in fact, persuaded by Navarro's opinion and, if so, the ALJ failed “to address all the limitations in the opinion and either include them in the RFC or provide sufficient explanation for why they were not included.” (ECF No. 8:15.) Chavarria highlights the lack of mention, in the persuasiveness analysis or RFC, of limitations regarding exposure to dusts, odors, fumes, and pulmonary irritants. (Id. at 15-16.)
Chavarria concedes that “the ALJ employed essentially the same standing, walking, lifting[,] and carrying limitations in her RFC assessment as those found in Ms. Navarro's opinion.” (Id. at 14); see also (id. at 15) (observing “the incorporation of many of the same limitations in the ALJ's RFC as appear in Ms. Navarro's opinion”). The Commissioner argues that this undermines Chavarria's claim of harmful error. (ECF No. 11:4.) Specifically, the Commissioner says, “Plaintiff does not show that the limitations Ms. Navarro included in her opinion would preclude [Chavarria] from performing her past relevant work at step four.” (Id. at 5); see also (id.) (stating that “Plaintiff's past relevant work as a waitress/cashier and counter supervisor are classified as light jobs, and Plaintiff fails to show [that] the limitations in Ms. Navarro's opinion would preclude her from performing them” (citing (R:43-44) and relevant sections of the Dictionary of Occupational Titles (“DOT”))). The Commissioner also notes that the ALJ need not “base the RFC on any particular [medical] opinion,” but only needs to “interpret[] the medical evidence to determine a claimant's capacity for work.” (Id. at 5-6) (citing Miller, 2023 WL 234773 at *4).
The Court agrees with the Commissioner. Chavarria does not show that, had the ALJ properly assessed the supportability of Navarro's opinion, the ALJ would have adopted the opinion, and that such a turn of events could conceivably lead to a different outcome in Chavarria's case. Miller, 2023 WL 234773 at *4; Keel, 986 F.3d at 556. Rather, Chavarria asks the Court to speculate that the ALJ meant to adopt Navarro's opinion, which the Court cannot do. Newton, 209 F.3d at 455 (holding that the ALJ's decision “must stand or fall with the reasons set forth in the ALJ's decision, as adopted by the Appeals Council”). Further, regardless of the extent to which the ALJ found Navarro's opinion persuasive, she need not account for every limitation opined by Navarro, such as that regarding exposure to dusts, odors, fumes, and pulmonary irritants. See Fletcher v. Comm'r, SSA, No. 4:21-CV-00173-SDJ-CAN, 2022 WL 3130860, at *8 (E.D. Tex. June 21, 2022) (collecting cases holding that “[t]here is no requirement that the ALJ adopt any single medical opinion in its entirety”), report and recommendation adopted, No. 4:21-CV-173-SDJ, 2022 WL 3107905 (E.D. Tex. Aug. 4, 2022); Wilson v. Kijakazi, No. 4:21-CV-3964, 2022 WL 17742005, at *5 (S.D. Tex. Nov. 17, 2022) (collecting cases holding that “[t]he ALJ is not required to create an RFC that corresponds exactly with the medical opinions of record”), report and recommendation adopted, No. H:21-3964, 2022 WL 17738736 (S.D. Tex. Dec. 16, 2022). Thus, Chavarria does not show that the ALJ's erroneous supportability assessment was prejudicial. The Court further finds that substantial evidence supports the ALJ's decision. Therefore, remand is not warranted.
2. Other Issues and Harmless Error
Although Chavarria's brief claims to present only one issue, i.e., that the ALJ failed to comply with 20 C.F.R. § 404.1520c, she embeds additional issues calling for separate discussion. First, Chavarria disagrees with the ALJ's characterization of Navarro's opinion as being “suggestive of medium work.” (ECF No. 8:13) (citing R:43, 403). She argues that Navarro's opinion instead suggests a “light work” capacity because she limited Chavarria's lifting and carrying capabilities to twenty pounds on a frequent basis, whereas 20 C.F.R. § 404.1567(c) qualifies medium work as involving frequent lifting and carrying of up to twenty-five pounds. (Id.). Chavarria does not explain how such alleged mischaracterization affected the ALJ's decision-making. For the same reasons discussed in Section II.D.1.a supra, the Court finds that any error in characterization of Navarro's opinion would be harmless because the ALJ found Chavarria capable of working previous jobs that are characterized as light work. See (R:43-44.)
Second, Chavarria argues that remand is warranted because the ALJ's opinion is “internally inconsistent and confusing.” (ECF No. 8:14, 17) (citing Vinning, 2009 WL 920192 at *5). Specifically, she highlights that the ALJ found the opinions of Dr. Jeanine Kwun and Dr. Kim Rowlands “mostly persuasive” even though those opinions contain “similar limitations to Ms. Navarro with respect to standing, walking, lifting[,] and carrying,” but the ALJ “ma[de] no reference to what specific evidence was consistent with and supportive of Drs. Kwun and Rowlands' opinions.” (Id. at 13-14) (citing (R:43)). Chavarria does not explain how such alleged error affected the ALJ's decision-making. Nor does she expand on any potential argument that the ALJ's persuasiveness assessment of Dr. Kwun's and Dr. Rowlands's opinions was insufficient. Without deciding whether the ALJ erred for writing an “internally inconsistent and confusing” opinion, the Court finds that, for the same reasons discussed in Section II.D.1.a supra, substantial evidence supports the ALJ's decision and Chavarria has failed to show harmful error. Therefore, remand is not warranted.
III. CONCLUSION
For the foregoing reasons, the Court RECOMMENDS that the decision of the Commissioner be AFFIRMED pursuant to 42 U.S.C. § 405(g).