Bullock v. Saul ( 2023 )

UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF COLUMBIA
PAUL BULLOCK,
Plaintiff,
v. No. 20-cv-1764-ZMF
KILOLO KIJAKAZI,
Acting Commissioner of Social Security,
Defendant.
MEMORANDUM OPINION
Plaintiff Paul Bullock (“Mr. Bullock”) moves for reversal of Defendant Commissioner of
the Social Security Administration’s (“SSA” or “Commissioner”) decision adopting the findings
of an Administrative Law Judge (“ALJ”) in denying Mr. Bullock’s application for Supplemental
Security Income. See Pl.’s Mot. J. Reversal (“Pl.’s Mot.”), ECF No. 18. The Commissioner moves
for affirmance. See Def.’s Mot. J. Affirmance & Opp’n Pl.’s Mot. J. Reversal (“Def.’s Mot.”),
ECF No. 19. Having considered the parties’ submissions and the Administrative Record, 1 the court
will DENY Mr. Bullock’s Motion for Judgment Reversal and GRANT the Commissioner’s
Motion for Judgment of Affirmance in an accompanying order.
I. BACKGROUND
A. Statutory Framework
The Social Security Act (the “Act”) provides benefits for “disabled” individuals. 42 U.S.C.
§ 423(a)(1). The Act defines “disability” as the “inability to engage in any substantial gainful
1
The Administrative Record consists of sixty-nine exhibits. See Administrative R., ECF No. 9.
For ease of reference citations to the Administrative Record will refer to the “AR” and cite to the
consecutive page numbers provided in the lower right-hand corner of each page.
1
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[.]” Id.§ 423(d)(1)(A). The impairment must be severe and must render the individual unable to perform
both “previous work” and “any other kind of substantial gainful work which exists in the national
economy[.]” Id. § 1382c(a)(3)(B); see 20 C.F.R. § 416.905(a).
The SSA uses a five-step sequential process to determine whether a claimant is disabled.
See 20 C.F.R. § 416.920(a)(4). If a determination can be made at any step, the SSA does not go on
to the next step. See id. The burden of proof is borne by the claimant at each of the first four steps
and switches to the Commissioner at step five. See Butler v. Barnhart, 353 F.3d 992, 997 (D.C.
Cir. 2004) (citing 20 C.F.R. §§ 404.1520(f), 416.920(f)). At step one, the claimant must
demonstrate he is not presently engaged in “substantial gainful activity[.]” 20 C.F.R. § 416.920(a)(4)(i). At step two, the claimant must show that he has a “severe medically determinable”
impairment that “significantly limits [his] physical or mental ability to do basic work activities[.]”
Id. §§ 416.920(a)(4)(ii), (c). At step three, the claimant must show that his impairment—or
combination of impairments—“meets or equals” the criteria of an impairment listed in the
Commissioner’s regulations. Id. § 416.920(a)(4)(iii). If the claimant’s impairment does not meet
or equal a listed impairment, the Commissioner proceeds to step four, which requires the
Commissioner to determine the claimant’s residual functional capacity (“RFC”) 2 and whether,
considering the RFC, the claimant can still perform any relevant past work. See id.
§§ 416.920(a)(4)(iv), (e)–(f). If the RFC indicates that the claimant cannot engage in past work,
2
The RFC assessment is “what an individual can still do despite his or her limitations . . . [and
reflects an individual’s] maximum remaining ability to do sustained work activities.” SSR 96-8p,
1996 WL 374184, at *2 (July 2, 1996).
2
then at step five, the ALJ looks to the claimant’s RFC, age, education, and work experience to
determine if he can perform “other work” in the national economy. Id. §§ 416.920(a)(4)(v), (g).
B. Factual Background
Mr. Bullock is an adult male with an eleventh-grade education. See AR 37, 197. He
previously worked as a landscaper and was last employed as a laborer in 2013. See AR 72.
Mr. Bullock alleged his disability began on August 1, 2016, asserting an inability to work due to
major depressive disorder, anxiety disorder, post-traumatic stress disorder (“PTSD”), irritability,
anger, and asthma. See AR 196. During the ALJ hearing, Mr. Bullock testified that he had also
been diagnosed with insomnia and that his sleeping medication made it “hard for [him] to get
up[.]” AR 42. Mr. Bullock confirmed that he was homeless and lived with either a friend or in a
shelter. See AR 36. He testified that he could participate in daily activities such as cleaning, caring
for his therapy cat, seeing his daughters, and using the Internet. See AR 45–47.
Mr. Bullock has been treated and evaluated by numerous medical and psychological
professionals throughout his life. See AR 482–502, 504–506, 544–642. On June 26, 2017, Greg
Mathis, LPC, found Mr. Bullock had moderate impairments in his “ab[ility] to fulfill social
responsibilities, to interact with others, maintain [] physical functioning . . . [and] self-care[,]” but
“maintain[ed] control of any impulsive, aggressive or abusive behaviors.” AR 565.
Mr. Bullock reported improved symptoms when compliant with a medication regimen. See
AR 426. However, one of the drugs, Trazodone, caused excessive sleepiness and nightmares,
which caused Mr. Bullock to stop taking it. See AR 49. Despite improvements, Mr. Bullock has a
history of noncompliance with his medication and treatment plans. See AR 390, 394. On December
4, 2018, Dr. Colleen Hawthorne, MD, evaluated Mr. Bullock after he was noncompliant with his
medication. See AR 829. Dr. Hawthorne found that his “mood disturbances, angry outbursts, low
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frustration tolerance, social isolation, and anhedonia . . . contributed to his limited social and
vocational functioning.” AR 505 (cleaned up). But Dr. Hawthorne noted that Mr. Bullock did not
have any suicidal ideation and demonstrated normal judgment, attention, and speech; good insight;
and intact memory. See AR 833–34. Dr. Hawthorne determined that Mr. Bullock had “no
limitation in understanding, remembering, and applying information[;] . . . moderate difficulties
maintaining concentration, persistence, or pace; and moderate difficulties adapting or managing
oneself.” AR 21. Dr. Hawthorne concluded that Mr. Bullock was unable to work. See AR 21.
On October 3, 2019, Emmanuel Sango, RN, prescribed Mr. Bullock medication to treat his
nightmares and sleep disturbances and stabilize his mood after Mr. Bullock stopped taking the
medication prescribed to him in 2017. See AR 872.
State and agency psychological consultants also evaluated Mr. Bullock. See AR 63–73,
76–88. Dr. Patrica Cott, Ph.D., reviewed Mr. Bullock’s medical record. See AR 68. On November
22, 2017, Dr. Cott found that Mr. Bullock’s mental impairments resulted in moderate limitations
in understanding, remembering, and applying information; interacting with others; maintaining
concentration, persistence, or pace 3 (“CPP”); and adapting or managing oneself. See AR 69–71.
Dr. Cott further concluded he was “able to complete tasks during a standard work day and week
with limited contact with the public or others who might trigger anger.” AR 71.
On April 13, 2018, Dr. Nancy Heiser, Ph.D., found Mr. Bullock had moderate limitations
in his ability to carry out detailed instructions, maintain attention and concentration for extended
periods, complete a workday without interruptions, interact with the public, respond to changes in
his work environment, and make plans independently from others. See AR 83–84. Ultimately,
3
CPP is “the ability to sustain focused attention and concentration sufficiently long to permit the
timely and appropriate completion of tasks commonly found in work settings.” Johnson v. Saul,
No. 19-cv-3829, 2021 WL 411202, at *5 (D.D.C. Feb. 5, 2021) (cleaned up).
4
Dr. Heiser found no severe limitations and determined that Mr. Bullock was not disabled. See AR
76–87.
C. Procedural History
On October 20, 2017, Mr. Bullock applied for disability benefits. See AR 74. On January
5, 2018, the SSA denied his claim. See AR 73. Mr. Bullock requested a timely hearing before an
ALJ, which was held on December 10, 2019. See AR 30.
On January 17, 2020, the ALJ denied Mr. Bullock’s claim. See AR 12–23. At step one, the
ALJ determined that Mr. Bullock had not engaged in substantial gainful activity since the alleged
onset date. See AR 14. At step two, the ALJ determined that Mr. Bullock had the following severe
impairments: depressive disorder, personality disorder, trauma disorder, and substance abuse
disorder. See AR 14. At step three, the ALJ determined that Mr. Bullock’s “impairment or
combination of impairments [did not meet] or medically equal[] the severity of one of the listed
impairments in 20 CFR Part 404, Subpart P, Appendix 1 (20 CFR 416.920(d), 416.925 and
416.926).” AR 15.
At step four, the ALJ determined that Mr. Bullock had the RFC to perform a full range of
work with exertional levels, with limitations. See AR 16. Specifically, the ALJ limited Mr. Bullock
to occupations with no contact with the public; only occasional coworker contact and supervision;
set routines, procedures, and instructions; and few changes during the workday. See AR 16–17.
Additionally, the ALJ determined that Mr. Bullock could not “climb ladders, ropes or scaffolds;
. . . must avoid all exposure to hazards, such as dangerous machinery and unprotected heights; and
[could not] drive vehicular equipment.” AR 16. Finally, the ALJ asserted that Mr. Bullock could
“work with below average work production pressures; . . . maintain regular attendance and be
punctual within customary tolerances, and perform activities within a schedule.” AR 17.
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Finally, at step five, the ALJ determined that when considering Mr. Bullock’s RFC, “there
[were] jobs that exist[ed] in significant numbers in the national economy that [Mr. Bullock] c[ould]
perform[.]” AR 22. The vocational expert (“VE”) testified that an individual with Mr. Bullock’s
characteristics could perform the requirements of the representative occupations of kitchen helper,
laundry worker, and floor waxer. See 56. Thus, the ALJ ruled that Mr. Bullock was not disabled.
See AR 23.
On January 17, 2020, Mr. Bullock requested a review of the ALJ’s Decision. See AR 1.
On April 23, 2020, the Appeals Council denied his request. See AR 1. On June 6, 2020,
Mr. Bullock filed the complaint in this matter. See Compl., ECF No. 1. On November 9, 2021, the
parties consented to proceed before a magistrate judge for all purposes. See Min. Order (Nov. 15,
2021). On May 9, 2023, this case was directly reassigned from Magistrate Judge Meriweather to
Magistrate Judge Faruqui. See Reassignment Civ. Case, EFC No. 26.
II. LEGAL STANDARD
A district court sits in what is essentially an appellate role when it reviews the
Commissioner’s disability determination, which must be upheld “if it is supported by substantial
evidence and is not tainted by an error of law.” Smith v. Bowen, 826 F.2d 1120, 1121 (D.C. Cir.
1987). Substantial evidence is “such relevant evidence as a reasonable mind might accept as
adequate to support a conclusion.” Butler, 353 F.3d at 999 (quoting Richardson v. Perales, 402
U.S. 389, 401 (1971)). This standard “requires more than a scintilla, but can be satisfied by
something less than a preponderance of the evidence.” Fla. Mun. Power Agency v. Fed. Energy
Regul. Comm’n, 315 F.3d 362, 365–66 (D.C. Cir. 2003) (cleaned up).
“Substantial-evidence review is highly deferential to the agency fact-finder.” Rosello ex
rel. Rosello v. Astrue, 529 F.3d 1181, 1185 (D.C. Cir. 2008). “An ALJ’s credibility determinations,
6
in particular, ‘are entitled to great deference.’” Harrison Cnty. Coal Co. v. Fed. Mine Safety &
Health Rev. Comm’n, 790 F. App’x 210, 212 (D.C. Cir. 2019) (quoting Sec’y of Labor v. Keystone
Coal Mining Corp., 151 F.3d 1096, 1107 (D.C. Cir. 1998)). “The reviewing court may neither
reweigh the evidence presented to it nor replace the Commissioner’s judgment ‘concerning the
credibility of the evidence with its own.’” Goodman v. Colvin, 233 F. Supp. 3d 88, 104 (D.D.C.
2017) (quoting Crosson v. Shalala, 907 F. Supp. 1, 3 (D.D.C. 1995)). But the ALJ must have built
a “logical bridge” between the evidence and her conclusions so that this Court may “assess the
validity of the agency’s ultimate findings and afford a claimant meaningful judicial review.” Lane-
Rauth v. Barnhart, 437 F. Supp. 2d 63, 67 (D.D.C. 2006) (quoting Scott v. Barnhart, 297 F.3d
589, 595 (7th Cir. 2002)).
On review, the “plaintiff bears the burden of demonstrating that the Commissioner’s
decision [was] not based on substantial evidence or that the incorrect legal standards were applied.”
Settles v. Colvin, 121 F. Supp. 3d 163, 169 (D.D.C. 2015) (quoting Muldrow v. Astrue, 2012 WL
2877697, No. 11-cv-1385, at *6 (D.D.C. July 11, 2012)). If the ALJ is found to have applied the
correct legal standards and met the substantial evidence threshold, then the reviewing court may
grant the Commissioner’s motion for an affirmance of the disability determination. See, e.g., Hicks
v. Astrue, 718 F. Supp. 2d 1, 17 (D.D.C. 2010). If a reviewing court finds that an ALJ erred in his
determination that a claimant was not disabled, it may reverse and remand, requiring the SSA to
conduct further proceedings consistent with the law. See, e.g., Jackson v. Barnhart, 271 F. Supp.
2d. 30, 38 (D.D.C. 2002).
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III. DISCUSSION
Substantial evidence supports the ALJ’s finding. The ALJ properly conducted the RFC
analysis and adequately considered Mr. Bullock’s limitations in CPP, daily activities, medication
side effects, and medical opinions.
A. ALJ Properly Based Conclusion on Substantial Evidence
Medical Source Statements
“ALJs must articulate in their decisions how persuasive they find each medical opinion.”
Demetria R. v. Kijakazi, No. 20-cv-3227, 2022 WL 3142376, at *21 (D.D.C. June 30, 2022), R. &
R. adopted, 2022 WL 3139026 (D.D.C. Aug. 5, 2022). “Supportability and consistency are the key
factors when assessing the persuasiveness of medical opinions.” Id. (citing 20 C.F.R.
§ 416.1520c(b)(2)). 4 An ALJ must explain how he considered supportability and consistency in
his opinion. See 20 C.F.R. §§ 404.1520c(b)(2), 416.920c(b)(2). ALJs must also assess other factors
listed in the regulations “but [are] not required to” expressly explain that consideration in their
decisions. Id. §§ 404.1520c(b)(2), 416.920c(b)(2). When there are “[e]qually persuasive medical
opinions or prior administrative medical findings about the same issue, . . . [ALJs must] articulate
how [they] considered the other most persuasive factors . . . in [their] determination or decision.”
Id. § 404.1520c(b)(3).
The ALJ found Dr. Cott and Heiser to be persuasive. See AR 21. Mr. Bullock asserts
Dr. Hawthorne’s opinion was more persuasive than the ALJ gave credit, 5 see AR 21, but this
4
Supportability refers to “the objective medical evidence and supporting explanations provided
by a medical source.” 20 C.F.R. §§ 404.1520c(c)(1), 416.920c(c)(1). Consistency refers to the
consistency between the medical source’s opinion and “the evidence from other medical sources
and nonmedical sources[.]” Id. §§ 404.1520c(c)(2), 416.920c(c)(2).
5
One such reason was that Dr. Hawthorne was the treating physician. See Pl.’s Reply at 6. “The
treating physician’s rule’ required an ALJ to give ‘controlling weight’ to a treating physician's
8
invites “the Court to reweigh the evidence in [Mr. Bullock’s] favor—which the Court cannot do[.]”
Demetria R., 2022 WL 3142376, at *22 (cleaned up). “In other words, even if [Dr. Hawthorne’s]
opinion was persuasive in some respects, the Court must defer to the contrary finding of the ALJ
so long as it is supported by substantial evidence, which, again as the D.C. Circuit and Supreme
Court have recently explained, is a ‘low bar.’” Id. (quoting La. Pub. Serv. Comm’n v. Fed. Energy
Regul. Comm’n, 20 F.4th 1, 7 (D.C. Cir. 2021)).
“That ‘low bar’ is cleared here.” Demetria R., 2022 WL 3142376, at *22 (cleaned up). The
ALJ reviewed how Dr. Cott’s moderate limitation finding was consistent with the record evidence.
See AR 21. For example, Dr. Cott found that Mr. Bullock could complete tasks during the workday
with little exposure to others based on his feelings of anger and paranoia toward others improving
when compliant with treatment and medications. See AR 21, 70–71. The ALJ further explained
that Dr. Heiser’s evaluation confirmed Dr. Cott’s findings. Indeed, Dr. Heiser addressed the same
symptoms as Dr. Hawthorne—“problems with anger and irritability”—but concluded that a
limitation “to routine tasks with infrequent interactions with the public” would still allow
Mr. Bullock to work. AR 85; see AR 21. The ALJ noted that these findings were consistent with
Mr. Bullock’s daily activities. See AR 21. Drawing on the record, the ALJ then concluded that
Mr. Bullock was of “average intelligence, normal judgment, normal attention, good insight, intact
memory, and normal speech,” with or without compliance with medication. AR 21.
medical opinion if it was ‘well-supported by medically acceptable clinical and laboratory
diagnostic techniques and [was] not inconsistent with the other substantial evidence in [the] case
record[.]’ 20 C.F.R. § 416.927(c)(2). [However, the] ‘treating physician’s rule’ does not apply to
cases[—such as this one—]filed on or after March 27, 2017.” Ronald D. v. Comm’r of Soc. Sec.,
No. 20-cv-197, 2021 WL 6133909, at *4 (D. Vt. Dec. 29, 2021) (citing 20 C.F.R. §§ 416.927;
416.920c).
9
Moreover, the ALJ explained why he discounted Dr. Hawthorne’s statements in certain
aspects but credited them in others. See AR 21–22. The ALJ noted that Dr. Hawthorne’s
determinations did not account for Mr. Bullock’s inconsistent compliance with his medication. See
AR 21. This is a factor that Dr. Hawthorne should have considered. See Elder v. Berryhill, 774 F.
App’x 980, 983 (7th Cir. 2019) (ALJ did not err in considering claimant’s inconsistent compliance
with prescribed medication in disability determination). And Dr. Hawthorne’s opinion “was based
only on a one-time examination[,]” which explains why it was inconsistent with the record. Hobbs
v. Saul, No. 20-cv-4, 2021 WL 1574421, at *10 (W.D. Va. Apr. 22, 2021); see AR 366, 375. The
ALJ explained that he also discounted Dr. Hawthorne’s findings over internal inconsistencies:
Dr. Hawthorne asserted Mr. Bullock had marked limitations interacting with others and moderate
difficulties in CPP and adapting oneself but noted Mr. Bullock had “average intelligence normal
judgment, normal attention, good insight, intact memory, and normal speech.” AR 506; see AR
21. The ALJ further explained that Dr. Hawthorne’s finding that Mr. Bullock could not work was
“extreme and unpersuasive” given Dr. Hawthorne’s observation that Mr. Bullock had no limitation
in understanding, remembering, and applying information. AR 20; see AR 21. “That is substantial
evidence, and other courts have found similar discounting of physician’s opinions to be
appropriate.” Demetria R., 2022 WL 3142376, at *22 (collecting cases).
Daily Activities
ALJs may consider a claimant’s daily activities when evaluating the severity and credibility
of reported impairments. See 20 C.F.R. § 416.929(c)(3); SSR 16-3p, 2017 WL 5180304, at *7.
Hence, ALJs regularly consider daily activities when assessing plaintiffs’ claims about limited
work capacity. See, e.g., Colter v. Kijakazi, No. 20-cv-632, 2022 WL 715218, at *13–14 (D.D.C.
Mar. 10, 2022); Grant v. Astrue, 857 F. Supp. 2d 146, 156–57 (D.D.C. 2012).
10
Mr. Bullock’s testimony about daily activities provides substantial evidence to support the
ALJ’s conclusion that Mr. Bullock was not disabled. See AR 21. For example, the ALJ noted that
Mr. Bullock could “fool[] around” on his phone, use public transportation, clean his house, see his
children anywhere from twice a month to twice a year, and live either at a homeless shelter or with
a friend, AR 51; see AR 44–46. The ALJ also noted that Mr. Bullock had no limitations in
performing personal care activities and pet care. See AR 17–28. These daily activities
“demonstrate[d] that while the claimant may be limited by his mental impairments, he c[ould] still
perform activities that require attention and concentration, as well as understand[] at least simple,
routine tasks and instructions.” AR 18; see Hall v. Kijakazi, 2022 WL 343504, No. 20-cv-2073, at
*6 (D.D.C. Feb. 4, 2022) (ALJ found that reported daily activities indicated the claimant was not
as limited as alleged). And “the ALJ did not reason that [Mr. Bullock’s] activities of daily living
[we]re as demanding as those of full-time work. Rather, the ALJ considered [Mr. Bullock’s]
activities to determine whether [his] symptoms were as severe and limiting as []he alleged.” Jeske
v. Saul, 955 F.3d 583, 592–93 (7th Cir. 2020); see AR 18.
“Were these [] statements to be the only times where the ALJ addressed Plaintiff’s daily
activities as part of his analysis as to [Mr. Bullock’s] subjective complaints of [his] symptoms,
Plaintiff would have a more compelling case.” Colter, 2022 WL 715218, at *14 (cleaned up).
“However, the ALJ’s opinion makes clear that he recognized and understood Plaintiff’s alleged
limitations as to [his] ability to perform daily activities.” Id. For example, the ALJ noted “contrary
hearing testimony”: Mr. Bullock reported fatigue, low energy and trouble concentrating, only
getting four to six hours of sleep a night, not having a driver’s license because he was too afraid
to drive, and only seeing his four daughters when their mother permitted. Laura A. v. Kijakazi, No.
21-cv-451, 2022 WL 3644810, at *17 (D.D.C. Aug. 24, 2022); see AR 17–18. “So, like in Colter,
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contrary to Plaintiff’s insinuations, the ALJ did not ignore or disregard [his] testimony as to the
extent to which []he [could or could not] perform [his] daily activities. Rather, as the ALJ
explained, he found that Plaintiff’s alleged severity of symptoms was not entirely in accord with
[his] professed daily activities, taking into account the relevant limitations.” Laura A., 2022 WL
3644810, at *17 (cleaned up).
“More importantly, and as in Colter, the ALJ here did not rely solely on the discrepancies
between Plaintiff’s testimony and [his] daily activities in concluding that [his] symptoms were not
disabling.” Id. “Instead, the ALJ considered Plaintiff’s medical records, treatment records, and the
opinions of medical experts and found that the record as a whole undermined some of [his]
subjective complaints.” Colter, 2022 WL 715218, at *14; see AR 17–22. Moreover, the ALJ
accounted for Mr. Bullock’s credible symptoms by limiting the available work to below-average
work production pressures to manage stress exacerbating Mr. Bullock’s symptoms, and to limited
contact with coworkers and no contact with the public to manage Mr. Bullock’s “anger complaints
and his reported history of panic symptoms[.]” AR 20.
Making these detailed findings demonstrated that the ALJ “did not assume [Mr. Bullock
could] work solely based on [daily] activities.” Jeanine J. v. Kijakazi, No. 21-cv-4044, 2022 WL
4483812, at *5 (C.D. Ill. Sept. 27, 2022). In all, over five pages the ALJ discussed how myriad
evidence supported his determination. See AR 17–22. This is more comprehensive than the norm.
Compare Lane-Rauth, 437 F. Supp. 2d at 68 (“[T]he ALJ’s ruling spen[t] three pages simply listing
the plaintiff’s entire medical history and then conclusively stating that . . . claimant . . . could
perform sedentary work.”), with Williams v. Colvin, 134 F. Supp. 3d 358, 365 (D.D.C. 2015)
(remanding the case when the ALJ did not explain any basis for his findings). Thus, the ALJ
created a logical bridge between Mr. Bullock’s credible symptoms and abilities, and the conclusion
12
that jobs existed in the national economy that Mr. Bullock could perform. See Colter, 2022 WL
715218, at *15; AR 22.
B. The ALJ Conducted a Proper RFC Assessment
In determining Mr. Bullock’s RFC, the ALJ “buil[t] an accurate and logical bridge from
the evidence to his conclusion,” properly accounting for the side effects of Mr. Bullock’s
medication and his mild or moderate limitations in CPP. Laura A., 2022 WL 3644810, at *11
(cleaned up).
The RFC was Appropriately Tailored
“In essence, an RFC assessment is a function-by-function assessment of a claimant’s
physical and mental work-related capabilities used to determine what an individual can still do
despite his or her limitations.” Johnson v. Kijakazi, No. 18-cv-2749, 2022 WL 2452610, at *2
(D.D.C July 6, 2022) (cleaned up). The assessment “must include a narrative discussion describing
how the evidence supports each conclusion . . . citing specific medical facts . . . and nonmedical
evidence.” Id. (cleaned up). The narrative discussion is not an “articulation of each function and
its implication on the ALJ’s overall conclusion,” rather it must allow a reviewing court to
determine that an ALJ “consider[ed] the [whole] record and discuss[ed] which evidence he found
credible and why.” Gregory v. Kijakazi, No. 21-cv-2115, 2022 WL 7463984, at *5 (D.D.C. Oct.
12, 2022) (cleaned up).
Here, the ALJ thoroughly examined both the medical and nonmedical evidence and
concluded that Mr. Bullock was able to perform work at all exertional levels with the following
limitations:
- Physical: cannot climb ladders, ropes, or scaffolds, must avoid all hazards, cannot drive
vehicular equipment;
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- Mental: able to understand and carry out simple, routine instructions, able to sustain
concentration for two-hour periods at a time, able to use judgment in making work
decisions, able to work with below-average work production pressure; and
- Social: only occasional coworker contact and supervision and no contact with the
public.
See AR 16–17. The ALJ further explained how his evaluation of evidence—such as medical
opinions, daily activities, Mr. Bullock’s testimony, and the VE’s testimony—informed his final
determination that Mr. Bullock was not disabled within the meaning of the Act. See AR 17–22.
Thus, “the ALJ did more than merely list the evidence.” Pinkney v. Astrue, 675 F. Supp. 2d. 9, 17–
18 (D.D.C. 2009). Instead, “[t]he ALJ explained which evidence he found credible and why,”
while providing a sufficient explanation of Mr. Bullock’s limitations. Id. at 18. In so doing, the
ALJ built a logical bridge to his conclusion, allowing this Court to assess the validity of the
agency’s ultimate findings and afford Mr. Bullock meaningful judicial review. See id. at 17.
Medication’s Sedative Side Effects
Relevant evidence in the disability determination includes “how functioning may be
affected by factors including . . . medication[.]” 20 C.F.R. § 404.1520a(c)(1). It is “an ALJ’s duty
to develop a full record [which] can include investigating the side effects of medications.” Walker
v. Comm’r of Soc. Sec., 404 F. App’x 362, 366 (11th Cir. 2010). “Consideration of the side effects
of medication applies to both the assessment of functional limitations and the RFC assessment.”
Lomax v. Comm’r of Soc. Sec., No. 20-cv-55, 2021 WL 3508087, at *6 (D.D.C Aug. 4, 2021)
(cleaned up).
The ALJ stated that he considered “the type, dosage, effectiveness, and side effects of any
medication the individual takes or has taken.” AR 18 (emphasis added). Mr. Bullock alleges that
14
the ALJ failed to address the side effect of drowsiness from his medication. See Pl.’s Reply at 3.
“We have previously observed that drowsiness often accompanies the taking of medication, and it
should not be viewed as disabling unless the record references serious functional limitations[.]”
Rutherford v. Barnhart, 399 F.3d 546, 555 (3d Cir. 2005) (cleaned up). Neither the medical records
nor Plaintiff’s testimony demonstrated that Mr. Bullock’s drowsiness was disabling. See AR 42,
49; see also Caitlin v. Kijakazi, No. 17-cv-1939, 2022 WL 17370231, at *23–24 (D.D.C. Oct. 27,
2022) (ALJ correctly determined claimant was not disabled despite chronic fatigue disorder,
insomnia, and medication side effects by relying on evidence including medical opinions, medical
records, and testimony). Indeed, Mr. Bullock said he “just [got] tired,” and that it was difficult to
wake up in the morning. AR 43, see AR 40. 6
The cases Mr. Bullock cited are distinguishable. See Pl.’s Mot. at 13. For example, in
Martin v. Apfel, the Court reversed the ALJ’s decision because the ALJ ignored uncontradicted
testimony from the Plaintiff that his medications caused him to be excessively drowsy. 118 F. Supp.
2d 9, 16, 18–19 (D.D.C. 2000). And in Newton v. Apfel, the ALJ considered on remand Plaintiff’s
ability to remain gainfully employed given that she had to visit the doctor often and that her
treatment caused her to sleep for several hours during the day. 209 F.3d 448, 459 (5th Cir. 2000).
These complaints are more severe than Mr. Bullock’s. Mr. Bullock did claim that the medication’s
side effects made him sleep during the day, let alone in such extreme amounts. See AR 42, 49.
“An ALJ’s discretion is at its apex when weighing evidence and testimony.” Lomax, 2021
WL 3508087, at *8. The ALJ specifically mentioned the claimant’s “sleep difficulties” after
starting new medication in 2017 and that the claimant reported low energy and fatigue in October
6
Mr. Bullock testified Trazodone caused excessive drowsiness. See AR 49. But because
Mr. Bullock stopped taking the drug, the ALJ did not need to consider its impact. See AR 49.
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2019. See AR 18–19. This demonstrates that the ALJ weighed Mr. Bullock’s drowsiness when
making his determination. See Grant, 857 F. Supp. 2d at 156 (court found ALJ properly
acknowledged claimant’s reported drowsiness but found reported daily activities supported a
finding of no disability). The record, including Mr. Bullock’s daily activities, supported the ALJ’s
decision to find that this side effect was not disabling. See id.; AR 44–47, 51. Thus, substantial
evidence supports the ALJ’s determination, which adequately considered and explained the
medication side effects on Mr. Bullock. See Grant, 857 F. Supp. 2d at 156.
Moderate Limitation in CPP
The ALJ found Mr. Bullock had a moderate limitation in CPP. See AR 15. This “means
that the claimant’s functioning in this area independently, appropriately, effectively, and on a
sustained basis [wa]s fair.” Laura A., 2022 WL 3644810, at *11 (cleaned up). Fair is “commonly
understood to mean not very good or very bad: of average or acceptable quality.” Id. (cleaned up).
Mr. Bullock alleges that “[a]s a matter of law, finding moderate limitations in the domain
of [CPP] requires an additional finding of diminished ability to stay on task.” Pl.’s Mot. at 12. This
conclusion is based on the premise that “the ability to perform simple tasks differs from the ability
to stay on task. Only the latter limitation would account for a claimant’s limitation in [CPP].” Petty
v. Colvin, 204 F. Supp. 3d 196, 206 (D.D.C. 2016). Mr. Bullock is incorrect. A finding of moderate
limitations in CPP does not require a finding of diminished ability to stay on task, rather it requires
that the RFC and the hypotheticals provided by the ALJ “adequately accounts for a claimant’s
moderate limitations in [CPP].” Id. Further, “an ALJ’s decision is not necessarily internally
inconsistent when an impairment is found to be severe[,] . . . [but] found not disabling[.]” McIntyre
v. Colvin, 758 F.3d 146, 151 (2d Cir. 2014). But an ALJ cannot merely limit work to simple,
routine, and unskilled tasks to account for a claimant’s moderate CPP limitations. See id.; Mascio
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v. Colvin, 780 F.3d 632, 638 (4th Cir. 2015) (remanded because the ALJ did not explain how
claimant’s limitation in CPP did not affect their ability to work and did not include any mental
limitations in the hypothetical provided to the VE).
Here, the ALJ adequately explained how Mr. Bullock’s RFC limitations accounted for his
CPP limitation. The ALJ found that Mr. Bullock had a moderate limitation in CPP but stated Mr.
Bullock’s daily activities—such as watching TV, reading, using the Internet, and handling his
medical care—showed that his limitations were not debilitating. See AR 15. The ALJ stated that
Mr. Bullock could “sustain attention and concentration for two-hour periods at a time and for eight
hours in the workday on short simple routine instructions.” AR 16. Further, the ALJ explained that
despite Mr. Bullock being “distractable,” AR 18, and his symptoms being “worsened by
complicated situational stressors” and noncompliance with his medication, 7 AR 19, Mr. Bullock
retained the ability to understand, remember, and carry out short, simple, routine instructions. See
AR 20. The ALJ’s conclusion drew upon Mr. Bullock’s daily activities and Dr. Hawthorne’s
testimony that Mr. Bullock had “normal attention,” good insight, intact memory, and normal
speech. AR 21; see AR 70, 85. Thus, substantial evidence supports the ALJ’s conclusion. See
Mcintyre, 758 F.3d at 152 (substantial evidence supported ALJ’s determination and the
explanation of limitations sufficiently accounted for claimant’s impairments) (cleaned up).
Moreover, the hypothetical that the ALJ provided to the VE “adequately” captured
Mr. Bullock’s limitation on CPP by using time and complexity limitations. Petty, 204 F. Supp. 3d
at 206; see AR 56. Compare White v. Comm’r of Soc. Sec., 572 F.3d 272, 288 (6th Cir. 2009) (ALJ
explicitly stated to VE that claimant had moderate limitations in CPP), with Winschel v. Comm’r
7
See Darlene M. v Kijakazi, No. 20-cv-1817, 2021 WL 6841641, at *22 (D.D.C. Sept. 3, 2021)
(failure to comply with medication treatment was factor ALJ could consider when assigning
weight to subjective evidence on symptoms provided by claimants).
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of Soc. Sec., 631 F.3d 1176, 1180–81 (11th Cir. 2011) (ALJ did not indicate that medical evidence
suggested the claimant’s ability to work was unaffected by CPP limitation nor implicitly accounted
for the limitation in the hypothetical posed to the VE). The VE concluded that a claimant with such
limitations could perform occupations that exist in the national economy. See AR 56. The ALJ
thereby sufficiently accounted for Mr. Bullock’s ability to stay on task with the VE and properly
considered the VE’s opinion in his RFC determination. See Smith v. Halter, 307 F.3d 377, 379
(6th Cir. 2001) (ALJ did not explicitly include limitation of CPP but accounted for it implicitly by
restricted complexity and quota limits).
IV. CONCLUSION
For the foregoing reasons, as set out in an accompanying order, the Court will DENY
Plaintiff’s Motion for Judgment of Reversal and GRANT Defendant’s Motion for Judgment of
Affirmance.
2023.08.0
8 10:49:07
Date: August 8, 2023 -04'00'
___________________________________
ZIA M. FARUQUI
UNITED STATES MAGISTRATE JUDGE
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