Opinion
5:22-CV-138-D
08-18-2023
SHERRI LAMM, Plaintiff, v. KILOLO KIJAKAZI, Acting Commissioner of Social Security, Defendant.
MEMORANDUM AND RECOMMENDATION
Brian S. Meyers, United States Magistrate Judge.
This matter is before the court on the parties' cross-motions for judgment on the pleadings [DE-17, -20] pursuant to Fed.R.Civ.P. 12(c). Plaintiff Sherri Lamm (“Plaintiff” or, in context, “Claimant”) filed this action pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3) seeking judicial review of the denial of her application for a period of disability and Supplemental Security Income (“SSI”). Both parties submitted memoranda in support of their respective motions. [DE-18, -21]. Plaintiff responded to Defendant's motion for judgment on the pleadings [DE-22] and the time for filing a reply has expired. Accordingly, the pending motions are ripe for adjudication. The motions were referred to the undersigned magistrate judge for a memorandum and recommendation pursuant to 28 U.S.C. § 636(b)(1). Having carefully reviewed the administrative record and the motions and memoranda submitted by the parties, it is recommended that Plaintiff's Motion for Judgment on the Pleadings [DE-17] be denied, Defendant's Motion for Judgment on the Pleadings [DE-20] be allowed, and the final decision of the Commissioner be upheld.
I. STATEMENT OF THE CASE
Plaintiff protectively filed an application for a period of disability and SSI on November 15, 2019, alleging disability beginning November 27, 2016. Transcript of Proceedings (“Tr.”) 77- 92, 262-70. Plaintiff's alleged onset date was subsequently amended to November 15, 2019. Tr. 15, 67. Her claim was denied initially. Tr. 77-92. Plaintiff filed a request for reconsideration (Tr. 118) and was denied upon reconsideration on December 9, 2020 (Tr. 93-117). On December 21, 2020, Plaintiff requested a hearing before the Administrative Law Judge (“ALJ”). Tr. 146-49. A hearing before the ALJ was held on June 2, 2021, at which Plaintiff, represented by counsel, and a vocational expert (“VE”) appeared and testified. Tr. 61-76. Due to technological issues, the hearing concluded unexpectedly. Tr. 15, 76. The hearing resumed on June 16, 2021, and concluded that same day. Tr. 36-60. On July 9, 2021, the ALJ issued a decision denying Plaintiff's request for benefits. Tr. 12-35.
On September 23, 2021, Plaintiff requested a review of the ALJ's decision by the Appeals Council. Tr. 249-50. On March 17, 2022, the Appeals Council denied Plaintiff's request for review. Tr. 1-6. Plaintiff then filed a complaint in this court seeking review of the now-final administrative decision.
II. STANDARD OF REVIEW
The scope of judicial review of a final agency decision regarding disability benefits under the Social Security Act (“Act”), 42 U.S.C. § 301 et seq., is limited to determining whether substantial evidence supports the Commissioner's factual findings and whether the decision was reached through the application of the correct legal standards. See Coffman v. Bowen, 829 F.2d 514, 517 (4th Cir. 1987). “The findings of the Commissioner . . . as to any fact, if supported by substantial evidence, shall be conclusive ....” 42 U.S.C. § 405(g). Substantial evidence is “evidence which a reasoning mind would accept as sufficient to support a particular conclusion.” Laws v. Celebrezze, 368 F.2d 640, 642 (4th Cir. 1966). While substantial evidence is not a “large or considerable amount of evidence,” Pierce v. Underwood, 487 U.S. 552, 565 (1988), it is “more than a mere scintilla . . . and somewhat less than a preponderance.” Laws, 368 F.2d at 642. “In reviewing for substantial evidence, [the court should not] undertake to re-weigh conflicting evidence, make credibility determinations, or substitute [its] judgment for that of the [Commissioner].” Mastro v. Apfel, 270 F.3d 171, 176 (4th Cir. 2001) (quoting Craig v. Chater, 76 F.3d 585, 589 (4th Cir. 1996), superseded by regulation on other grounds, 20 C.F.R. § 416.927(d)(2)). Rather, in conducting the “substantial evidence” inquiry, the court's review is limited to whether the ALJ analyzed the relevant evidence and sufficiently explained his or her findings and rationale in crediting the evidence. Sterling Smokeless Coal Co. v. Akers, 131 F.3d 438, 439-40 (4th Cir. 1997). “Judicial review of an administrative decision is impossible without an adequate explanation of that decision by the administrator.” DeLoatche v. Heckler, 715 F.2d 148, 150 (4th Cir. 1983).
III. DISABILITY EVALUATION PROCESS
The disability determination is based on a five-step sequential evaluation process as set forth in 20 C.F.R. § 416.920 under which the ALJ is to evaluate a claim:
The claimant (1) must not be engaged in “substantial gainful activity [“SGA”],” i.e., currently working; and (2) must have a “severe” impairment that (3) meets or exceeds [in severity] the “listings” of specified impairments, or is otherwise incapacitating to the extent that the claimant does not possess the residual functional capacity [“RFC”] to (4) perform . . . past work or (5) any other work.Albright v. Comm'r of the Soc. Sec. Admin., 174 F.3d 473, 475 n.2 (4th Cir. 1999). “If an applicant's claim fails at any step of the process, the ALJ need not advance to the subsequent steps.” Pass v. Chater, 65 F.3d 1200, 1203 (4th Cir. 1995) (citation omitted). The burden of proof and production during the first four steps of the inquiry rests on the claimant. Id. At the fifth step, the burden shifts to the ALJ to show that other work exists in the national economy which the claimant can perform. Id.
When assessing the severity of mental impairments, the ALJ must do so in accordance with the “special technique” described in 20 C.F.R. §§ 416.920a(b)-(c). This regulatory scheme identifies four broad functional areas in which the ALJ rates the degree of functional limitation resulting from a claimant's mental impairment(s): understanding, remembering, or applying information; interacting with others; concentrating, persisting, or maintaining pace; and adapting or managing oneself. Id. § 416.920a(c)(3). The ALJ is required to incorporate into his written decision pertinent findings and conclusions based on the “special technique.” Id. § 416.920a(e)(4).
IV. ALJ'S FINDINGS
Applying the above-described sequential evaluation process, the ALJ found Plaintiff “not disabled” as defined in the Act. Tr. 30.
At step one, the ALJ determined Plaintiff had not engaged in substantial gainful employment since November 15, 2019, the alleged onset date. Tr. 17.
Next, at step two, the ALJ determined Plaintiff had the following severe impairments: morbid obesity; degenerative disc disease of the cervical and lumbar spines; degenerative joint disease of the sacroiliac joints and bilateral knees; depression; bipolar disorder; and anxiety/panic disorder. Tr. 17. The ALJ also found Plaintiff had the following non-severe impairments: hypertension; hyperlipidemia; gastroesophageal reflux disease (“GERD”); hypothyroidism; bronchitis; diabetes; plantar fasciitis; sinus infection; sinusitis; headache; cough; carpal tunnel syndrome; pharyngitis; hiatal hernia; fatty liver; diverticulosis; rash; angina/acute coronary syndrome; gastroparesis; cystitis; pyelonephritis; recurrent urinary tract infections/cystitis; vitamin D deficiency; ovarian cyst; vaginal discharge; furuncle; reflux esophagitis; constipation; abnormal white blood cell count; episode of acute hearing loss; candidiasis of vulva and vagina; loss of visual acuity; pulmonary embolism; atelectasis; tremors; otitis media; breast calcifications; kidney infection; vaginitis; acute swimmer's ear; neck strain; sensorineural hearing loss; rhinitis; labyrinthitis; asthma/chronic obstructive pulmonary disorder (“COPD”); cirrhosis; nonalcoholic steatosis; and obstructive sleep apnea. Tr. 18.
However, at step three, the ALJ concluded these impairments, both physical and mental, were not severe enough, either individually or in combination, to meet or medically equal one of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1. Tr. 19. Applying the technique prescribed by the regulations, the ALJ found that Plaintiff's mental impairments have resulted in moderate limitation in understanding, remembering, or applying information; moderate limitation in interacting with others; moderate limitation in concentrating, persisting, or maintaining pace; and moderate limitation in adapting or managing oneself. Tr. 21.
Prior to proceeding to step four, the ALJ assessed Plaintiff's RFC, finding Plaintiff had the ability to perform light work with the following limitations:
“Light work involves lifting no more than 20 pounds at a time with frequent lifting or carrying of objects weighing up to 10 pounds. Even though the weight lifted may be very little, a job is in this category when it requires a good deal of walking or standing, or when it involves sitting most of the time with some pushing and pulling of arm or leg controls. To be considered capable of performing a full or wide range of light work, you must have the ability to do substantially all of these activities. If an individual can perform light work, he or she can also perform sedentary work, unless there are additional limiting factors such as the loss of fine dexterity or the inability to sit for long periods of time.” 20 C.F.R. § 416.967(b). “Sedentary work involves lifting no more than 10 pounds at a time and occasionally lifting or carrying articles like docket files, ledgers, and small tools. Although a sedentary job is defined as one which involves sitting, a certain amount of walking and standing is often necessary in carrying out job duties. Jobs are sedentary if walking and standing are required occasionally and other sedentary criteria are met.” 20 C.F.R. § 416.967(a); S.S.R. 96-9p, 1996 WL 374185, at *3 (July 2, 1996). “Occasionally” generally totals no more than about 2 hours of an 8-hour workday. S.S.R. 96-9p, 1996 WL 374185, at *3. “Sitting” generally totals about 6 hours of an 8-hour workday. Id. A full range of sedentary work includes all or substantially all of the approximately 200 unskilled sedentary occupations administratively noticed in 20 C.F.R. Part 404, Subpart P, Appendix 2, Table 1. Id.
she can never climb ladders, scaffolds, or ropes. The claimant can occasionally climb ramps and stairs. She can occasionally balance as that term is defined in the Dictionary of Occupational Titles. The claimant can occasionally stoop, kneel, crouch, and crawl. She must avoid concentrated exposure to hazards such as unprotected heights, dangerous machinery, and sharp objects. She can understand, remember, and carry out simple instructions, which is defined to mean activity that is consistent with a reasoning level of “one” or “two” as defined in the Dictionary
of Occupational Titles. The claimant can sustain concentration, attention, and pace sufficient enough to carry out those simple instructions over the course of an eighthour workday and at two-hour intervals. She can work in occupations that require only occasional contact with coworkers, supervisors, and the general public. The claimant can work in a low-stress setting, which is specifically defined to mean: no fast-paced production, only simple work related decisions, and few or no changes in the work setting.Tr. 22.
In making this assessment, the ALJ found Plaintiff's statements about her limitations not entirely consistent with the medical evidence and other evidence in the record. Tr. 23.
At step four, the ALJ concluded that Plaintiff did not have any past relevant work. Tr. 28.
Nonetheless, at step five, upon considering Plaintiff's age, education, work experience, and RFC, the ALJ determined that there is work that exists in significant numbers in the national economy that Plaintiff can perform. Tr. 29.
V. OVERVIEW OF PLAINTIFF'S CONTENTIONS
In this case, Plaintiff alleges the ALJ erred by failing to incorporate non-exertional limitations on the ability to stay on task where the ALJ first finds that Plaintiff was moderately impaired in the maintenance of concentration, persistence, or pace (CPP). Pl.'s Mem. [DE-18] at 5.
Except for citations to the Transcript of Proceedings (“Tr.”), all citations to documents using the docket entry number [DE-] provided in the court's docket will specify the page number automatically assigned by the CM/ECF system, rather than the page number, if any, specified in the original document.
VI. DISCUSSION
Plaintiff contends that the ALJ erred by failing to incorporate non-exertional limitations on the ability to stay on task where the ALJ first finds that Plaintiff was moderately impaired in the maintenance of CPP. Pl.'s Mem. [DE-18] at 5. The court disagrees.
Specifically, at issue is whether the ALJ sufficiently accounts for Plaintiff's moderate impairment in maintaining CPP by finding that Plaintiff:
[can] understand, remember, and carry out simple instructions, which is defined to mean activity that is consistent with a reasoning level of “one” or “two” as defined in the Dictionary of Occupational Titles[;] can sustain concentration, attention, and pace sufficient enough to carry out those simple instructions over the course of an eight-hour workday and at two-hour intervals[;] can work in occupations that require only occasional contact with coworkers, supervisors, and the general public[; and] can work in a low-stress setting, which is specifically defined to mean: no fast-paced production, only simple work related decisions, and few or no changes in the work setting.Tr. 22.
“A Social Security claimant's RFC represents ‘the most [she] can still do despite [her] limitations.'” Dowling v. Comm'r of Soc. Sec. Admin., 986 F.3d 377, 387 (4th Cir. 2021) (alterations in original) (quoting 20 C.F.R. § 416.945(a)(1)). It is “an administrative assessment of ‘an individual's ability to do sustained work-related physical and mental activities in a work setting on a regular and continuing basis' despite impairments and related symptoms.” Brooks v. Berryhill, No. 2:16-CV-80-FL(2), 2018 WL 944382, at *3 (E.D. N.C. Jan. 23, 2018) (quoting SSR 96-8p, 1996 WL 374184, at *1 (July 2, 1996)). An RFC assessment must be “based on all of the relevant medical and other evidence.” Ward v. Colvin, 90 F.Supp.3d 510, 513 (E.D. N.C. 2015) (citing 20 C.F.R. § 404.1545(a)(3)). In making this assessment, “the ALJ must consider all of the claimant's medically determinable impairments of which the ALJ is aware, including those not labeled severe at step two.” Shinaberry v. Saul, 952 F.3d 113, 119 (4th Cir. 2020) (quoting Monroe v. Colvin, 826 F.3d 176, 178 (4th Cir. 2016)).
“[A] proper RFC analysis has three components: (1) evidence, (2) logical explanation, and (3) conclusion.” Thomas v. Berryhill, 916 F.3d 307, 311 (4th Cir. 2019), as amended (Feb. 22, 2019). The ALJ “must include a narrative discussion describing how the evidence supports each conclusion, citing specific medical facts (e.g., laboratory findings) and nonmedical evidence (e.g., daily activities, observations).” Monroe, 826 F.3d at 189 (quoting Mascio v. Colvin, 780 F.3d 632, 636 (4th Cir. 2015)). Where a court is “left to guess about how the ALJ arrived at his conclusions on [a claimant's] ability to perform relevant functions . . ., remand is necessary.” Mascio, 780 F.3d at 637. Additionally, “[r]emand may be appropriate . . . where an ALJ fails to assess a claimant's capacity to perform relevant functions, despite contradictory evidence in the record, or where other inadequacies in the ALJ's analysis frustrate meaningful review.” McNeill v. Saul, No. 5:20-CV-244-M, 2021 WL 3701348, at *3 (E.D. N.C. June 2, 2021) (alterations in original) (quoting Mascio, 780 F.3d at 636).
In Mascio, the Fourth Circuit held “that an ALJ does not account ‘for a claimant's limitations in concentration, persistence, and pace by restricting the hypothetical question to simple, routine tasks or unskilled work.'” Mascio, 780 F.3d at 638 (quoting Winschel v. Comm'r of Soc. Sec., 631 F.3d 1176, 1180 (11th Cir. 2011)). Specifically, the court found that “the ability to perform simple tasks differs from the ability to stay on task[,]” and “[o]nly the latter limitation would account for a claimant's limitation in concentration, persistence, or pace.” Id. However, the Fourth Circuit does “not impose a categorical rule that requires an ALJ to always include moderate limitations in concentration, persistence, or pace as a specific limitation in the RFC.” Shinaberry, 952 F.3d at 121. Instead, the Fourth Circuit notes “that ‘an ALJ can explain why [a claimant's] moderate limitation in concentration, persistence, or pace at step three does not translate into a limitation' in the claimant's RFC.” Id. (quoting Mascio, 780 F.3d at 638) (alteration in original). “For example, the ALJ may find that the concentration, persistence, or pace limitation does not affect [the claimant's] ability to work, in which case it would [be] appropriate to exclude it from the hypothetical tendered to the vocational expert.” Id. (alterations in original) (citations omitted). Yet, without such explanation by the ALJ, remand is required. Williams v. Saul, No. 4:20-CV-92-FL, 2021 WL 3399820, at *4 (E.D. N.C. June 16, 2021) (citing Mascio, 780 F.3d at 638); see also Shannon R. v Kijakazi, 2022 WL 636638, at *9-10 (W.D. Va. Mar. 4, 2022) (finding that the ALJ “was required either to include specific work-related restrictions within her RFC finding to accommodate for such ‘moderate' CPP limits, or to explain why such limits did not translate into [the claimant's] RFC.”); and Linda W. v. Saul, 2021 WL 930274, at *4-6 (W.D. Va. Feb. 22, 2021) (“[T]he ALJ failed to draw an explicit conclusion or satisfactorily explain how [the claimant's] [moderate limitations in maintaining CPP] affect her ability to perform job-related tasks for a full eight-hour workday.”).
“While the ability to perform simple tasks differs from the ability to stay on task,” Mascio, 780 F.3d at 638, this court and the Fourth Circuit have previously found that certain limitations addressing the (1) speed of production, (2) the complexity of instructions, and (3) the interval of work segments can sufficiently address a claimant's ability to stay on task. See Simmons v. Berryhill, No. 5:17-CV-00004-D, 2018 WL 577243, at *7 (E.D. N.C. Jan. 10, 2018), report and recommendation adopted, No. 5:17-CV-4-D, 2018 WL 576845 (E.D. N.C. Jan. 26, 2018) (“[A]dditional limitations for work that involves no quotas or fast-paced production work with uninvolved oral and written instructions in two-hour segments . . . address [claimant's] ability to stay on task.”); Sizemore v. Berryhill, 878 F.3d 72, 79, 81 (4th Cir. 2017) (holding that limitations to completing simple one, two-step tasks in a low stress, non-production job without any fastpaced work and with no public contact were sufficient to account for moderate limitations in concentration, persistence, or pace).
While restricting the complexity of instructions alone is not sufficient to accommodate a moderate limitation in maintaining CPP, the Fourth Circuit has nonetheless considered this to be a legitimate component of an RFC that appropriately accommodates a claimant's moderate limitation in the ability to stay on task. Sizemore, 878 F.3d at 81 (“[D]espite [Plaintiff's] overall moderate difficulties with concentration, persistence, or pace, he would nonetheless be able to stay on task while performing ‘simple one, two-step tasks,' as long as he was ‘working in low stress nonproduction jobs with no public contact.'”) (emphasis added).
Here, the current ALJ's limitations are similar to those accepted by this court and the Fourth Circuit above and address the (1) speed of production, i.e., “no fast-paced production” (Tr. 22); (2) the complexity of instructions, i.e., “simple instructions, which is defined to mean activity that is consistent with a reasoning level of ‘one' or ‘two' as defined in the Dictionary of Occupational Titles” (id.); and (3) the required break intervals, i.e., “two-hour intervals” (id.).
The undersigned notes that while activity with a reasoning level of “two,” as defined in the Dictionary of Occupational Titles, goes beyond simple one- or two-step instructions, as included in Sizemore, 878 F.3d at 81, it nonetheless limits the complexity of instructions. See DICTIONARY OF OCCUPATIONAL TITLES Appendix C: Components of the Definition Trailer available at https://occupationalinfo.org/appendxc1 html (last visited August 18, 2023) (defining reasoning level two to consist of “[a]pply[ing] commonsense understanding to carry out detailed but uninvolved written or oral instructions [and] [d]eal[ing] with problems involving a few concrete variables in or from standardized situations.”).
The basic tenets of these limitations find their support in the opinions of the two State agency psychological consultants, Jonathan Mayhew, Ph.D., and Brett A. Fox, Psy.D. (“Dr. Fox”), who found that Plaintiff “should be able to maintain attention and concentration in order to complete simple, routine tasks” (Tr. 110; see also Tr. 88), which guides the complexity of the instructions, and that these occur “in a low stress environment,” (Tr. 112; see also Tr. 89), which guides the appropriate speed of production.
Plaintiff argues that “there is no support in the record for a capacity to perform these tasks in two-hour intervals . . . [as] [b]oth psychological consultants found limitations without a timed capacity for performance.” [DE-22] at 7. Plaintiff also argues that “a limitation to two-hour periods of work is no limitation at all . . . [as] [a] typical workday is organized with ‘a morning break, a lunch period, and an afternoon break at approximately 2-hour intervals.'” Id. (quoting SSR 96-9p: Policy Interpretation Ruling Titles II and XVI: Determining Capability to do Other Work-Implications of a Residual Functional Capacity for Less Than a Full Range of Sedentary Work, 1996 WL 374185, at *6 (July 2, 1996)) (citing Capps v. Berryhill, No. CBD-17-2438, 2018 WL 4616018, at *5 (D. Md. Sept. 26, 2018).
Plaintiff's arguments defeat themselves. Plaintiff notes that work in two-hour intervals is consistent with a typical workday. Accordingly, the two psychological consultants' implicit findings that Plaintiff can “complete a normal workday . . . without interruptions from psychologically based symptoms” (Tr. 88, 110) when limited to “simple routine repetitive tasks in a low stress environment” (Tr. 112), supports the appropriateness of two-hour intervals.
Plaintiff additionally notes that under Fourth Circuit precedent, limitations of (1) no work requiring a “production rate or demand pace,” (Pl.'s Mem. [DE-18] at 13 (quoting Thomas, 916 F.3d at 310, 312)), or (2) a “non-production oriented work setting,” (id. (quoting Perry v. Berryhill, 765 Fed.Appx. 869, 871 (4th Cir. 2019) (unpublished))), were considered “inexact” and not amendable to judicial review. Plaintiff argues that the ALJ's use of the term “no fast-paced production” is similarly undefined. Id. (quoting Tr. 22).
Defendants point instead to Sizemore, 878 F.3d at 80-81, in which the Fourth Circuit found that the opinions of two doctors provided substantial support for the ALJ's finding that, “despite [the claimant's] overall moderate difficulties with concentration, persistence, or pace, he would nonetheless be able to stay on task while performing ‘simple one, two-step tasks,' as long as he was ‘working in low stress non-production jobs with no public contact.'” 878 F.3d at 81.
The instant case is comparable to the situation in Sizemore rather than that in Thomas or Perry. In Thomas, the Fourth Circuit held that the ALJ “did not give us enough information to understand what [requiring a production rate or demand pace] mean[s].” 916 F.3d at 312. Similarly, the Fourth Circuit in Perry held that “the ALJ offered no explanation of her own for what she meant when she used the phrase ‘non-production oriented work setting' in assessing Perry's residual functional capacity.” Perry, 765 Fed.Appx. at 872.
However, the Perry court distinguished the fact pattern in Thomas and its own from the situation in Sizemore by noting that “the ALJ in Sizemore provided additional context [to the limitation of ‘non-production jobs'], explaining that the claimant could perform work only in a ‘low stress' setting, without any ‘fast-paced work' or ‘public contact,' to account for moderate limitations in concentration, persistence and pace.” Perry, 765 Fed.Appx. at 872 n.1 (quoting Sizemore, 878 F.3d at 79). “Those descriptors helped to explain the restriction intended by the ALJ, and allowed [the Sizemore court] to evaluate whether that restriction adequately accounted for the claimant's limitations.” Perry, 765 Fed.Appx. at 872.
Here, the ALJ adds context through descriptors that are similar to those in Sizemore. For example, the ALJ limits Plaintiff to “no fast-paced production,” in the context of a “in a low-stress setting.” Tr. 22; Cf. Sizemore, 878 F.3d at 79; see also Simmons, 2018 WL 577243, at *8 (performing judicial review and upholding limitations that included “occupations that would not require completion of a fixed number of production quotas or the performance of fast-paced, assembly work.”).
Plaintiff argues that the state agency psychological consultants never define “low stress setting” and the ALJ's definition is therefore unsupported by evidence. [DE-22] at 6. However, Dr. Fox provides the necessary context and support for this limitation when he notes that Plaintiff “would likely have some trouble in more demanding work settings where the expectations and work duties change frequently . . .[but] should be able to handle a more stable work routine.” Tr. 112. The references to “demanding work settings” (Tr.122) are congruent with a limitation to “no fast paced production,” (Tr. 22) while the reference to frequently changing expectations and work duties (Tr. 122) support the ALJ's limitation of “few or no changes in the work setting” (Tr. 22).
Similarly, the ALJ in Sizemore used a similar definition, defining “low stress setting” to mean “non-production jobs [without any] fast-paced work [and] with no public contact.” Sizemore, 878 F.3d at 79 (alterations in original).
In addition to the limitations themselves, the ALJ's opinion includes a thorough discussion of the medical evidence, including Plaintiff's reports of “difficulty with concentration” (Tr. 23), as well as the diagnosis and ongoing treatment of Plaintiff's “panic disorder, anxiety disorder, and major depressive disorder” (Tr. 24), as well as the multiple references to medical reports noting “intact memory and concentration” and normal mental status including “full orientation, concentration, and memory” (Tr. 24-26). The ALJ also discusses Plaintiff's activities of daily living, noting, in particular, that Plaintiff homeschooled and provided 24-hour care for her autistic son. Tr. 21.
Plaintiff alleges that the ALJ “cherry-picks bits from the record in order to support her RFC finding, emphasizing the relative periods of remission and minimizing the periods of exacerbation.” [DE-22] at 3. For example, Plaintiff cites a report from 2013 of Lawrence Rawls, M.D., “who noted that [Plaintiff] appeared, anxious, with signs of depression, depressed mood, with signs of anxiety, and had a panic attack during the session with shortness of breath, crying, and flushing.” [DE-22] at 2 (citing Tr. 631). When discussing this specific medical report, the ALJ addresses all of these categories in broad terms, expressly noting that Plaintiff “reported experiencing panic attacks that were triggered by exposure to crowds” (Tr. 23), that Plaintiff “endorsed sadness, difficulty with concentration” (id.), and that “[t]he records show that she was diagnosed with panic disorder, anxiety disorder, and major depressive disorder” (Tr. 24). Furthermore, the medical records in question were for a visit that occurred in February 2013, which is over six years before the amended alleged onset date. See Tr. 631.
Similarly, Plaintiff argues that with respect to a 2020 medical record, the ALJ inappropriately focused on a reference to Plaintiff's “happy mood” (Tr. 24), while ignoring the parts of the record providing “recipes for food to reduce anxiety, as well as giving contact numbers for respite care for her children, indicating [according to Plaintiff] that [Plaintiff's] illness was interfering with her ordinary domestic duties.” [DE-22] at 3 (citing Tr. 807). Plaintiff's reasoning is speculative and unsupported by evidence as these prescriptions do not inherently suggest Plaintiff was experiencing interference with the regular performance of domestic duties, nor do they contradict that Plaintiff had a normal mental status examination despite an underlying anxiety disorder and demanding responsibilities associated with the care of an autistic child. See Tr. 80507.
Plaintiff additionally argues that Plaintiff's homeschooling of her son is an insufficient basis for finding that additional limitations are not necessary. Pl.'s Mem. [DE-18] at 10 (discussing Tr. 21). Specifically, Plaintiff argues that the “24-hour care [of Plaintiff's son] due to his autism; [] would indicate that his curriculum and daily schedule would be unlike that of a typical workday.” Id. at 11. There is nothing in the record indicating that 24-hour care and homeschooling of an autistic child is less demanding than a typical workday, and it would be Plaintiff's burden to make any such showing. See Baldwin v. Barnhart, 444 F.Supp.2d 457, 462 (E.D. N.C. 2005), aff'd, 179 Fed.Appx. 167 (4th Cir. 2006) (citing English v. Shalala, 10 F.3d 1080, 1082 (4th Cir.1993)) (“The claimant bears the burden of proving that he is disabled under the Social Security Act.”).
As the ALJ readily acknowledges, “[t]o be sure, [Plaintiff] has severe impairments that are limiting.” Tr. 27. However, contrary to Plaintiff's assertion, the ALJ here appropriately accounts for Plaintiff's moderate CPP impairment in the RFC and “reading the ALJ's decision as a whole, the ALJ built the requisite, accurate and logical bridge from the evidence in the record to his finding as to [P]laintiff's residual functional capacity.” Emanuel v. Saul, No. 7:19-CV-202-FL, 2021 WL 1217309, at *4 (E.D. N.C. Mar. 31, 2021).
Accordingly, the court finds that remand is not required.
VII. CONCLUSION
For the reasons stated above, IT IS RECOMMENDED that Plaintiff's Motion for Judgment on the Pleadings [DE-17] be DENIED, Defendant's Motion for Judgment on the Pleadings [DE-20] be ALLOWED, and the final decision of the Commissioner be UPHELD.
IT IS DIRECTED that a copy of this Memorandum and Recommendation be served on each of the parties or, if represented, their counsel. Each party shall have until September 1, 2023 to file written objections to this Memorandum and Recommendation. The presiding district judge must conduct his own review (that is, make a de novo determination) of those portions of the Memorandum and Recommendation to which objection is properly made and may accept, reject, or modify the determinations in the Memorandum and Recommendation; receive further evidence; or return the matter to the magistrate judge with instructions. See, e.g., 28 U.S.C. § 636(b)(1); Fed.R.Civ.P. 72(b)(3); Local Civ. R. 1.1 (permitting modification of deadlines specified in local rules), 72.4(b), E.D. N.C. Any response to objections shall be filed within 14 days of the filing of the objections, and in no event later than September 8, 2023, whichever is earlier.
If a party does not file written objections to the Memorandum and Recommendation by the foregoing deadline, the party will be giving up the right to review of the Memorandum and Recommendation by the presiding district judge as described above, and the presiding district judge may enter an order or judgment based on the Memorandum and Recommendation without such review. In addition, the party's failure to file written 15 objections by the foregoing deadline will bar the party from appealing to the Court of Appeals from an order or judgment of the presiding district judge based on the Memorandum and Recommendation. See Wright v. Collins , 766 F.2d 841, 846-47 (4th Cir. 1985).