North Carolina Cases August 22, 2022: Figgs v. Kijakazi

Case Description

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MEMORANDUM AND RECOMMENDATION

Robert Boones, Jr. United States Magistrate Judge

This matter is before the court on the parties' cross-motions for judgment on the pleadings [DE-18, -23] pursuant to Fed.R.Civ.P. 12(c). Claimant Anita Respass Figgs (“Claimant”) filed this action pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3) seeking judicial review of the denial of her applications for a period of disability, Disability Insurance Benefits (“DIB”), and Supplemental Security Income (“SSI”) payments. The time for filing responsive briefs has expired, and the pending motions are ripe for adjudication. Having carefully reviewed the administrative record and the motions and memoranda submitted by the parties, it is recommended that Claimant's Motion for Judgment on the Pleadings be denied, Defendant's Motion for Judgment on the Pleadings be allowed, and the final decision of the Commissioner be affirmed.

I. STATEMENT OF THE CASE

Claimant protectively filed applications for a period of disability and DIB and for SSI on June 16, 2017, alleging disability beginning November 28, 2016, which was later amended to December 2, 2016. (R. 25, 323-35, 345). Both claims were denied initially and upon reconsideration. (R. 25, 131-214). A hearing before an Administrative Law Judge (“ALJ”) was

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held on June 11, 2020, at which Claimant, represented by counsel, and a vocational expert (“VE”) appeared and testified. (R. 25, 54-85). On July 1, 2020, the ALJ issued a decision denying Claimant's request for benefits. (R. 22-53). On May 13, 2021, the Appeals Council denied Claimant's request for review. (R. 1-7). Claimant then filed a complaint in this court seeking review of the now-final administrative decision.

IL 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

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findings and rationale in crediting the evidence. Sterling Smokeless Coal Co. v. Akers, 131 F.3d 438, 439-40 (4th Cir. 1997).

III. DISABILITY EVALUATION PROCESS

The disability determination is based on a five-step sequential evaluation process as set forth in 20 C.F.R. §§ 404.1520 and 416.920 under which the ALJ is to evaluate a claim:

The claimant (1) must not be engaged in “substantial gainful activity,” 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 to (4) perform ... past work or (5) any other work.

Albright v. Comm 'r of the SSA, 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. §§ 404.1520a(b)-(c) and 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. §§ 404.1520a(c)(3), 416.920a(c)(3). The ALJ is required to incorporate into his written decision pertinent findings and conclusions based on the “special technique.” Id. §§ 404.1520a(e)(3), 416.920a(e)(3).

In this case, Claimant alleges the ALJ erred in (1) finding Claimant was capable of performing work at a modified light exertion level, (2) improperly assessing Claimant's statements

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regarding the intensity, persistence, and limiting effects of her symptoms, (3) failing to find Claimant was disabled under Grid Rule 201.14, and (4) failing to accurately set forth all of Claimant's limitations in the hypothetical to the VE. Pl.'s Mem. [DE-19] at 26-33.

IV. ALJ'S FINDINGS

Applying the above-described sequential evaluation process, the ALJ found Claimant “not disabled” as defined in the Act. At step one, the ALJ found Claimant had not engaged in substantial gainful employment since December 2, 2016, the amended alleged onset date. (R. 27). Next, the ALJ determined Claimant had the severe impairments of cervical degenerative disc disease, lumbar degenerative disc disease with radiculopathy, peripheral edema, hypercholesterolemia, hypertension, obesity, and depression. (R. 27-28). However, at step three, the ALJ concluded these impairments 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. (R. 28-30). Applying the technique prescribed by the regulations, the ALJ found that Claimant's mental impairments have resulted in mild limitation in understanding, remembering, or applying information and interacting with others, marked limitation in concentrating, persisting, or maintaining pace, and moderate limitation in adapting or managing oneself. (R. 30).

Prior to proceeding to step four, the ALJ assessed Claimant's RFC, finding Claimant had the ability to perform light work with the following limitations:

frequent bilateral operation of foot controls and occasional balancing, kneeling, stooping, crouching, crawling, and climbing ramps, stairs, ladders, ropes, or scaffolds. She can occasionally work at unprotected heights, around moving

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mechanical parts, and in operation of a motor vehicle. She can further occasionally work in weather extremes, humidity and wetness, and in extreme cold and heat. The claimant is able to perform simple, routine, and repetitive tasks, but not at a production rate pace (e.g. assembly line work). She can have occasionally interact [sic] with supervisors, coworkers, and the general public.

(R. 30-45). In making this assessment, the ALJ found Claimant's statements about her limitations not entirely consistent with the medical and other evidence of record. (R. 31).

At step four, the ALJ concluded Claimant was unable to perform her past relevant work as a cashier/checker, fast food worker, or kitchen helper/cafeteria counter attendant. (R. 45). Nonetheless, at step five, upon considering Claimant's age, education, work experience, and RFC, the ALJ determined Claimant is capable of adjusting to the demands of other employment opportunities that exist in significant numbers in the national economy. (R. 46).

V. DISCUSSION

A. The RFC Assessment

Claimant contends the ALJ erred in formulating her RFC by failing to properly analyze Claimant's statements regarding her subjective symptoms and finding Claimant was capable of performing a reduced range of light work. Pl.'s Mem. [DE-19] at 26-31.

1. Claimant's Subjective Statements

Claimant contends the ALJ failed to properly assess her statements regarding the intensity, persistence, and limiting effects of her symptoms and their consistency with the medical evidence and other evidence of record where Claimant had a documented history of degenerative disc disease with radiculopathy and edema, Claimant consistently reported her symptoms to her medical providers, a consultative examination supports Claimant's testimony, the ALJ cherry picked facts to support his opinion, and the ALJ failed to consider Claimant's inability to afford treatment. Pl.'s Mem. [DE-19] at 30-31.

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Federal regulations 20 C.F.R. §§ 404.1529(a) and 416.929(a) provide the authoritative standard for the evaluation of subjective complaints of pain and symptomology, whereby “the determination of whether a person is disabled by pain or other symptoms is a two-step process.” Craig, 76 F.3d at 593-94. First, the ALJ must objectively determine whether the claimant has medically documented impairments that could cause his or her alleged symptoms. SSR 16-3p, 2016 WL 1119029, at *3 (Mar. 16, 2016); Hines v. Barnhart, 453 F.3d 559, 564 (4th Cir. 2006). If the ALJ makes that determination, he must then evaluate “the intensity and persistence of the claimant's pain[,] and the extent to which it affects her ability to work,” Craig, 76 F.3d at 595, including whether the claimant's statements are supported by the objective medical record. S.S.R. 16-3p, 2016 WL 1119029, at *4; Hines, 453 F.3d at 564-65.

Objective medical evidence may not capture the full extent of a claimant's symptoms, so where the objective medical evidence and subjective complaints are at odds, the ALJ should consider all factors concerning the “intensity, persistence and limiting effects” of the claimant's symptoms. SSR 16-3p, 2016 WL 1119029, at *7; 20 C.F.R. §§ 404.1529(c)(3), 416.929(c)(3) (showing a complete list of factors). The ALJ may not discredit a claimant solely because his or her subjective complaints are not supported by objective medical evidence, Craig, 76 F.3d at 595- 96, but neither is the ALJ required to accept the claimant's statements at face value; rather, the ALJ must “evaluate whether the statements are consistent with objective medical evidence and the other evidence.” SSR 16-3p, 2016 WL 1119029, at *6; see Taylor v. Astrue, No. 5:10-CV-263-FL, 2011 WL 1599679, at *4-8 (E.D. N.C. Mar. 23, 2011), adoptedby 2011 WL 1599667 (E.D. N.C. Apr. 26, 2011).

The ALJ recounted Claimant's hearing testimony as follows:

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The claimant alleged that she is physically unable to work due to pain in her shoulders, lower back, and neck. She testified to numbness in her extremities and alleged that she has constant numbness in her arm and hand. She further alleged that she is unable to reach overhead, but stated that her foot symptoms waxed and waned. She alleged that she was only able to walk for ten minutes and sit for ten to fifteen minutes before she began to feel symptoms and had to shift positions. She similarly complained of extreme limitations in her ability to lift or carry, alleging that she is only able to carry less than five pounds. She reported swelling in her hands and feet, but noted that her blood pressure was controlled with medication. She alleged that activity made her swelling worse and indicated that stretch exercises provided by her doctor were “out of the question.” Lastly, she noted problems with sleep and indicated that it takes her longer to do household chores due to pain.

(R. 31). The ALJ found that Claimant's impairments could reasonably be expected to cause the alleged symptoms, but that Claimant's statements about her limitations were not entirely consistent with the medical and other evidence. Id.

Claimant first argues that her documented history of degenerative disc disease with radiculopathy and edema predictably causes mental and physical limitations that she reported to her providers, her statements are corroborated by objective medical and other evidence, and the ALJ minimized, ignored, omitted, and rejected this evidence while cherry picking evidence that supported the non-disability determination. Pl.'s Mem. [DE-19] at 30-31. The AL J acknowledged Claimant's “longstanding history of degenerative disc disease” and thoroughly discussed Claimant's treatment records, including her complaints to her treatment providers of lumbar and cervical pain, tenderness of the spine on examination, pain with movement, generalized pain in her arms, legs, and back, radiating pain, neck pain, weakness in her arms and legs, tingling and numbness in her hands, muscle spasms, and poor sleep. (R. 31-37). However, the ALJ noted that many of Claimant's complaints were inconsistent over time, her use of an assistive device was inconsistent, physical examinations at times demonstrated some tenderness and limited range of motion of the spine and gait disturbance but were otherwise largely normal (e.g., normal gait,

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posture, sensation, reflexes, coordination, strength), Claimant gave questionable effort at times on testing, Claimant was treated with conservative measures such as NSAIDs and nerve and narcotic pain medication, and increased activity and exercise were recommended by her treatment providers. Id.; see (R. 476-83, 487-92, 543, 555-60, 575-78, 673-76, 700-07, 927-41, 946-48, 950-51,977-83, 1108-10, 1143-65, 1233-36, 1408-13, 1498-1516, 1525-40, 1551-69).

The ALJ concluded that,

[t]he claimant's statements regarding her condition are generally inconsistent with the available medical evidence, which supports no greater limitations than those outlined above. The claimant testified to extreme limitations in her ability to sit, stand, walk, lift, or carry. However, there is no evidence that she complained of such extreme limitations to her primary care physician[,] orthopedist, or pain management physician (Exhibit C18F, C19F, C20F, C21F). Furthermore, there are long periods within the record where she goes without outpatient treatment of her back complaints and her questionable effort and poor cooperation made it difficult for multiple consultative examiners to assess her functioning (Exhibit C2F, Cl IF). Additionally, during hospital examinations for her complaints, she consistently demonstrates normal motor function, normal strength, normal sensation, and a steady gait despite notes of paraspinal or spinal tenderness (Exhibit ClF, C7F, C9F, C14F, C16F). She also testified that she had swelling that was worse with activity. However, the record shows that she reported resolution of her lower extremity swelling during a January 2019 primary care visit without any evidence that she complained of any further similar symptoms thereafter (Exhibit C18F, C21F). Lastly, she testified that her depression and anxiety had gotten worse. However, she stated that her symptoms improved with medication and otherwise did not report any specific limitations attributable to her mental impairments.

(R. 42). The ALJ did not cherry pick facts but rather weighed the contradictory evidence in the record, as is his responsibility, and Claimant has pointed to no specific treatment record, or evidence therein, that the ALJ failed to consider, effectively asking the court to reweigh the evidence. See Hancock v. Astrue, 667 F.3d 470, 472 (4th Cir. 2012) (“In reviewing for substantial evidence, [the court does] not undertake to reweigh conflicting evidence, make credibility determinations, or substitute our judgment for that of the ALJ.”) (citation omitted).

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Claimant does specifically argue that the ALJ failed to consider Claimant's inability to afford treatment in assessing her complaints of pain and other symptoms. The ALJ must “consider and address reasons for not pursuing treatment that are pertinent to an individual's case,” including whether a claimant is unable to afford treatment and lacks access to free or low-cost medical services. SSR 16-3p, 2016 WL 1119029, at *10; see Gordon v. Schweiker, 725 F.2d 231, 237 (4th Cir. 1984) (“It flies in the face of patent purposes of the SSA to deny benefits to someone because he is too poor to obtain medical treatment that may help him.”). At the administrative hearing, the ALJ asked Claimant whether the entries in her medical records regarding her not taking her medications or having a CPAP machine were because she did not have health insurance, and Claimant answered in the affirmative. (R. 74). The ALJ also noted in the RFC discussion that in November 2015, Claimant reported during a hospital visit that she could not afford pain management treatment due to the costs, (R. 31), and in assessing Claimant's subjective complaints the ALJ noted that “there are long periods within the record where she goes without outpatient treatment of her back complaints.” (R. 42). The record does indicate, and the ALJ noted, that Claimant received vouchers for her medications on some occasions after she reported an inability to pay. (R. 38,491, 1452).

Although the ALJ did not directly address whether Claimant's failure at times to pursue treatment for her back pain was a result of her inability to afford care, the ALJ cited several other reasons for discounting Claimant's statements regarding her limitations. The ALJ found that Claimant had not reported to her treatment providers the severe limitations to which she testified, she had questionable effort and poor cooperation during consultative examinations making it difficult to assess her functioning, during hospital examinations she consistently demonstrated normal motor functioning, strength, sensation, and gait, and she made inconsistent statements

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about her lower extremity swelling. Id. Claimant's intermittent periods where she did not receive treatment was only one of many factors relied upon by the ALJ in assessing Claimant's subjective statements, and any error in not expressly considering the potential financial reason for gaps in treatment was harmless because the ALJ's determination is supported by other substantial evidence. See Williams v. Kijakazi, No. 2:20-CV-86-FL, 2022 WL 576396, at *10 (E.D. N.C. Feb. 3, 2022) (finding error in considering a claimant's missed therapy sessions without considering the ability to afford the treatment was not dispositive, because the ALJ cited other evidence that was sufficient to support the ALJ's assessment of Claimant's subjective statements regarding his limitations) (citing Dowling v. Comm'r of Soc. Sec. Admin., 986 F.3d 377, 383 (4th Cir. 2021) (“Substantial evidence is that which a reasonable mind might accept as adequate to support a conclusion. Though the threshold for such evidentiary sufficiency is not high, it requires that more than a mere scintilla of evidence support the ALJ's findings.”) (internal quotation marks and citations omitted)), report and recommendation adopted, 2022 WL 571469 (E.D. N.C. Feb. 24, 2022).

Claimant also contends that the limitations to which she testified are supported by the opinion of Dr. Bryant. Dr. Bryant conducted a consultative examination of Claimant on October 6, 2018. (R. 1128-34). He noted she did not seem to be a reliable historian. (R. 1128). On examination, Claimant had a slight reduction in muscle strength (rated 4 out of 5), normal sensory examination, positive bilateral straight-leg raise, normal reflexes, no joint swelling, and tenderness in the thoraco-lumbosacral spine. (R. 1131-32). She was able to lift, carry, and handle light objects, her fine and gross manipulative abilities were grossly normal, and she was able to squat and rise from that position to the level of 40 degrees and rise from a sitting position without assistance, but she had difficulty getting up and down from the exam table. (R. 1132). Claimant

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did not attempt to walk on heels or toes, tandem walking was normal, and she could stand but not hop on one foot bilaterally. Id. Dr. Bryant stated that Claimant had some decreased range of motion, but it was difficult to assess due to her questionable effort and lack of cooperation throughout the evaluation. (R. 1133). Dr. Bryant then concluded that Claimant had moderate limitations with sitting, standing and walking due to low back pain, needed an assistive device (a rolling walker) with regards to short and long distances and uneven terrain, had severe limitations with lifting and carrying weight due to low back pain, could perform occasional bending, stooping, crouching, squatting, and reaching due to low back pain, and could perform occasional grasping, handling, fingering, and feeling due to fatigue. (R. 1133-34).

The ALJ was not persuaded by Dr. Bryant's opinion regarding Claimant's limitations because Dr. Bryant's opinion was based on an evaluation where Claimant gave limited effort, appeared agitated with questioning regarding her alleged complaints, had difficulty giving a history of her symptoms and treatment, and was not cooperative. (R. 43). The ALJ also found that Dr. Bryant's opinion that Claimant required a rolling walker was contradicted by Claimant's limited and inconsistent use of an assistive device and generally normal motor strength, intact sensation, and normal gait just two months prior to Dr. Bryant's examination of Claimant. (R. 4344). Claimant did not challenge the ALJ's evaluation of Dr. Bryant's opinion, and the ALJ determined that, due to Claimant's lack of effort, Dr. Bryant's findings had limited credibility. See Dunn v. Colvin, 607 Fed.Appx. 264, 267 (4th Cir. 2015) (“An ALJ's determination as to the weight to be assigned to a medical opinion generally will not be disturbed absent some indication that the ALJ has dredged up ‘specious inconsistencies,' or has failed to give a sufficient reason for the weight afforded a particular opinion.”) (quoting Scivally v. Sullivan, 966 F.2d 1070, 1077 (7th Cir. 1992)).

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Accordingly, Dr. Bryant's opinion does not undermine the ALJ's decision to discount Claimant's subjective statements regarding her limitations.

The ALJ applied the appropriate framework in evaluating Claimant's statements regarding the limiting effects of her impairments, and the court can trace the ALJ's reasoning, which is supported by substantial evidence. Accordingly, the ALJ did not err in evaluating Claimant's subjective statements regarding her limitations.

2. Claimant's Ability to Perform a Reduced Range of Light Work

Claimant contends she is unable to physically perform a reduced range of light work because she cannot stand and walk for six hours in an eight-hour workday, citing her chronic degenerative disc disease with radiculopathy, numbness and tingling in the arms and hands that limit her ability to lift, carry, and hold objects, peripheral edema in her lower extremities that requires her to elevate her legs, her need to lie down during the workday to relieve her symptoms, and her pain that limits her ability to focus and stay on task. Pl.'s Mem. [DE-19] at 26-28.

The RFC is the capacity an individual possesses despite the limitations caused by physical or mental impairments. 20 C.F.R. §§ 404.1545(a)(1), 416.945(a)(1); see also S.S.R. 96-8p, 1996 WL 374184, at * 1 (July 2, 1996). The RFC is based on all relevant medical and other evidence in the record and may include a claimant's own description of limitations arising from alleged symptoms. 20 C.F.R. §§ 404.1545(a)(3), 416.945(a)(3); see also S.S.R. 96-8p, 1996 WL 374184, at *5. “[T]he residual functional capacity ‘assessment must first identify the individual's functional limitations or restrictions and assess his or her work-related abilities on a function-by-function basis, including the functions' listed in the regulations.” Mascio v. Colvin, 780 F.3d 632, 636 (4th Cir. 2015) (quoting S.S.R. 96-8p). The ALJ must provide “a narrative discussion describing how the evidence supports each conclusion, citing specific medical facts (e.g.,

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laboratory findings) and nonmedical evidence (e.g., daily activities, observations).” Id. (quoting S.S.R. 96-8p); see also Clifford v. Apfel, 227 F.3d 863, 872 (7th Cir. 2000) (observing that the ALJ “must build an accurate and logical bridge from the evidence to his conclusion”).

Claimant contends her chronic degenerative disc disease with radiculopathy requires her to lie down throughout the day. As discussed above, the ALJ thoroughly considered Claimant's back impairment and determined that, while it limited Claimant's functionality, she could still perform a reduced range of light work. The ALJ noted that Claimant's complaints were inconsistent over time, her use of an assistive device was inconsistent, physical examinations at times demonstrated some tenderness and limited range of motion of the spine but were otherwise largely normal, Claimant gave questionable effort at times on testing, Claimant was treated with conservative measures such as NSAIDs, nerve pain and narcotic pain medication, and increased activity and exercise were recommended by her treatment providers. (R. 31-37); see (R. 476-83, 487-92, 543, 555-60, 575-78, 673-76, 700-07, 927-41, 946-48, 950-51, 977-83, 1108-10, 1143-65, 1233-36, 1408-13, 1498-1516, 1525-40, 1551-69).

The ALJ also considered imaging from January 2020 that revealed facet arthropathy at the L5-L6 vertebrae with mild disc bulging narrowing the central canal and foramina; minimal right paracentral disc protrusion at the T5-T6 vertebrae that mildly effaced the ventral thecal sac and a disc osteophyte complex in the T6-T7 vertebrae with mild to moderate central canal narrowing, mild cord effacement, and mild right foraminal narrowing with mass effect on the exiting root; a small right foraminal disc protrusion at the T8-T9 vertebrae moderately narrowing the right neural foraminal and prominent facet arthropathy at the T10-T11 vertebrae with narrowing of the spinal canal, but no cord effacement; and mild degenerative changes in the lumbar spine. (R. 36, 1563- 64). Despite these positive findings, Claimant's orthopedist noted that her MRI findings were

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stable, she was not a surgical candidate, and she should focus on incorporating exercise into her lifestyle in addition to pain management. (R. 36-37, 1525-28, 1532-40, 1551-69). The ALJ found that the orthopedist's recommendations did not support a conclusion that Claimant was disabled from full time work. (R. 37); see Dunn, 607 Fed.Appx. at 275 (“[I]f all that the claimant needs is conservative treatment, it is reasonable for an ALJ to find that the alleged disability is not as bad as the claimant says that it is.”); Richardson v. Colvin, No. 4:14-CV-125-FL, 2015 WL 5725546, at *6 (E.D. N.C. Aug. 11, 2015) (concluding that conservative treatment lends little support to claims of debilitating symptoms), adopted by 2015 WL 5737613 (E.D. N.C. Sept. 30, 2015).

Claimant contends that the numbness and tingling in the arms and hands limits her ability to lift, carry, and hold objects. The ALJ acknowledged Claimant's intermittent complaints of numbness and tingling in her hands, but also noted that in many instances she denied associated weakness. (R. 31, 34-36, 503-04, 523, 537,1408-09,1527,1537,1556). The AL J also noted the October 2018 consultative examination finding that Claimant had a normal ability to lift, carry, and handle light objects, (R. 35, 1132), and the ALJ cited findings of intact sensation on examination, (R. 31-36,479,504, 518, 541,934,1115,1538). Although Claimant did demonstrate some decreased sensation in March 2020, the ALJ also noted that she demonstrated decreased effort during the examination. (R. 36, 1563).

Claimant also contends that her peripheral edema requires her to elevate her legs, which was not accommodated by the RFC. The ALJ acknowledged that Claimant's physician diagnosed her with peripheral edema in January 2019, despite no evidence of edema during the encounter, prescribed diuretic medication, and when Claimant returned to her physician she indicated her edema had resolved with medication, compression hose, and elevating her legs. (R. 38, 1143-45,

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1501, 1506). However, as the ALJ noted, the medical records largely reflect that Claimant had no edema on examination, (R. 38,674,702,927,931,945,1061,1109,1131,1527,1537,1563,1589, 1592), and no treatment provider, consultative examiner, or state agency doctor opined that Claimant was limited from work by the need to elevate her legs.

Finally, with respect to Claimant's assertion that her limited ability to focus and stay on task due to pain precludes her from performing any work, the ALJ noted that on examination Claimant routinely demonstrated good, focused attention and concentration. (R. 39-41, 1131, 1349, 1366, 1380). The ALJ also cited the January and November 2018 opinions of Dr. Richard Bing, which indicated Claimant retained the ability to sustain attention to perform simple and repetitive tasks. (R. 666-68, 1137-40). While the ALJ determined Claimant's ability to concentrate, persist, and maintain pace was markedly limited, which seems at odds with the ALJ's findings noted above, the ALJ included restrictions in the RFC to simple, routine, repetitive tasks, no work at a production rate pace (e.g., assembly line work), and only occasional contact with others to account for Claimant's mental limitations. (R. 41).

The ALJ discussed the medical evidence, opinion evidence, and Claimant's testimony, and cited evidence in the record to support the determination that Claimant had the RFC to perform a reduced range of light work. As explained above, it is not the court's role to reweigh the evidence. The court can trace the ALJ's reasoning in the RFC determination and finds it supported by substantial evidence. See Ladda v. Berryhill, 749 Fed.Appx. 166, 172 (4th Cir. 2018) (finding no error in the ALJ's RFC determination where the ALJ used evidence from the record to explain his finding that the claimant was capable of light work, explained the weight assigned to statements made by the claimant and the opinion evidence, and provided a thorough discussion allowing the court to conclude the RFC was supported by substantial evidence). Accordingly, the ALJ did not

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err in the RFC determination.

B. Grid Rule 201.14

Claimant contends that if the ALJ had determined that she was limited to work at the sedentary exertional level, then she would have been disabled by application of Grid Rule 201.14. Pl.'s Mem. [DE-19] at 31-32.

At step five of the sequential evaluation process, the burden is on the Commissioner to show that the claimant possesses the RFC to adjust to the demands of other work. 20 C.F.R. §§ 404.1520, 416.920. “If the claimant has no nonexertional impairments that prevent her from performing the full range of work at a given exertional level, the Commissioner may rely solely on the Grids to satisfy his burden of proof.” Aistrop v. Barnhart, 36 Fed.Appx. 145, 146 (4th Cir. 2002). The Grids also apply where “a rule . . . directs a conclusion that you are disabled based upon your strength limitations.” 20 C.F.R. §§ 404.1569a(d), 416.969a(d). Grid Rule 201.14 applies when an individual is, among other things, limited to sedentary work. 20 CFR pt. 404, subpt. P, app. 2, § 201.14. Here, because the ALJ determined Claimant could perform a limited range of light work, Grid Rule 201.14 is inapplicable, and the ALJ did not err in failing to apply it at step five.

C. The Hypothetical to the VE

Claimant contends the ALJ erred in failing to include all of Claimant's limitations in the hypothetical to the VE. Pl.'s Mem. [DE-19] at 32-33. This argument is foreclosed by the court's finding that the ALJ's RFC determination was without error.

The ALJ may utilize a VE at steps four and five “to assist the ALJ in determining whether there is work available in the national economy which this particular claimant can perform.” Walker v. Bowen, 889 F.2d 47, 50 (4th Cir. 1989). For a VE's opinion to be “relevant or helpful,”

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it must be given in response to a proper hypothetical question. Id. A proper hypothetical question “fairly set[s] out all of claimant's impairments” that are supported by the record. Id.; Russell v. Barnhart, 58 Fed.Appx. 25, 30 (4th Cir. 2003) (per curiam) (holding the ALJ's hypothetical question “adequately contemplated all of [claimant's] impairments and resulting limitations” as evidenced by the record). The additional limitations Claimant suggests the VE should have considered were not included in the RFC by the ALJ. Claimant's argument here is derivative of the RFC arguments addressed above and is rejected for the same reasons. The hypothetical to the VE included the limitations the ALJ found supported by the record that were ultimately imposed in the RFC. See King v. Berryhill, No. 2:17-CV-58-D, 2018 WL 6817036, at *8 (E.D. N.C. Dec. 6, 2018), adopted fry 2018 WL 6815651 (E.D. N.C. Dec. 27, 2018). Accordingly, the ALJ's hypothetical to the VE was without error.

VI. CONCLUSION

For the reasons stated above, it is RECOMMENDED that Claimant's Motion for Judgment on the Pleadings [DE-18] be DENIED, Defendant's Motion for Judgment on the Pleadings [DE-23] be ALLOWED, and the final decision of the Commissioner be AFFIRMED.

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 August 22, 2022 to file written objections to the Memorandum and Recommendation. The presiding district judge must conduct his or her 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

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specified in local rules), 72.4(b), E.D. N.C. Any response to objections shall be filed by within 14 days of the filing of the objections.

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 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).

Submitted, this the 22nd day of August, 2022.