Robyn Lynn Marie Snyder v. Comm'r of Soc. Sec.

NOT RECOMMENDED FOR PUBLICATION
File Name: 23a0239n.06
No. 22-5948
UNITED STATES COURT OF APPEALS
FOR THE SIXTH CIRCUIT
FILED
) May 26, 2023
ROBYN LYNN MARIE SNYDER, DEBORAH S. HUNT, Clerk
)
Plaintiff-Appellant, )
) ON APPEAL FROM THE UNITED
v. ) STATES DISTRICT COURT FOR
) THE EASTERN DISTRICT OF
COMMISSIONER OF SOCIAL SECURITY, ) KENTUCKY
Defendant-Appellee. )
) OPINION
Before: GRIFFIN, KETHLEDGE, and THAPAR, Circuit Judges.
PER CURIAM. Robyn Lynn Marie Snyder appeals the district court’s judgment affirming
the Commissioner of Social Security’s decision denying her application for disability insurance
benefits. For the reasons set forth below, we AFFIRM the district court’s judgment.
In December 2015, Snyder filed an application for disability insurance benefits, claiming
in relevant part that she was disabled as of June 25, 2013, due to chronic migraine headaches. Her
application proceeded to an evidentiary hearing before an administrative law judge (ALJ). The
ALJ found that Snyder’s headaches did not impose any significant work-related limitations in
function and therefore were a non-severe impairment under the Social Security regulations. The
ALJ found that Snyder’s severe impairments, which included affective disorder, anxiety disorder,
and post-traumatic stress disorder (PTSD), did not preclude her from performing jobs such as night
cleaner, bench worker, and document specialist. Accordingly, the ALJ concluded that Snyder was
not disabled and denied her application. The Appeals Council denied Snyder’s request for review.
No. 22-5948, Snyder v. Comm’r of Soc. Sec.
Snyder filed a timely complaint for judicial review of the Commissioner’s decision. In the
district court, the parties consented to a reversal of the ALJ’s decision and a remand of the case to
the Commissioner for further proceedings under sentence four of 42 U.S.C. § 405(g). On remand,
the Appeals Council ordered the ALJ to consider whether Snyder’s chronic migraine headaches
were a severe impairment under Social Security Ruling 19-4p, re-evaluate whether Snyder’s
combination of impairments was “severe” under 20 C.F.R. § 404.1523(c), reconsider Snyder’s
residual functional capacity (RFC), and, if warranted, obtain supplemental evidence from a
vocational expert (VE) on the effect of Snyder’s limitations on her occupational base.
The ALJ obtained a new medical opinion from a state-agency reviewing physician,
neurologist Dr. Lauren Frey, who stated that Snyder did not have a neurological impairment that
caused any physical functional impairment. The ALJ then held a second evidentiary hearing on
Snyder’s application, during which Snyder and a VE testified. Snyder testified that she suffered
from migraine headaches on a daily basis and that she spent most days lying in bed or on the couch.
She did little or no housework because it caused overheating, nausea, and vomiting. Various
treatment courses, such as Botox injections and lidocaine and ketamine drips, provided little or no
relief from her headaches. Light and noise exacerbated the pain of Snyder’s migraines, so she
wore earplugs and a hat and sunglasses to shield her eyes.
Based on the hypothetical provided by the ALJ, which eliminated jobs with even moderate
exposure to bright lighting and noise levels in excess of level three in the Dictionary of
Occupational Titles, the VE testified that Snyder could perform her past job as a coffee maker, as
well as other jobs such as document preparer, photocopy machine operator, and gate attendant.
According to the VE, these jobs existed in significant numbers in the national economy. On
cross-examination by Snyder’s attorney, the VE testified that Snyder would be precluded from
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competitive employment if she missed more than one day of work per month or had to take more
than three to four unscheduled breaks per day because of nausea and vomiting.
The ALJ denied Snyder’s claim. Proceeding through the five-step disability determination
sequence, see 20 C.F.R. § 404.1520, the ALJ first found that Snyder had not engaged in any
substantial gainful activity since the alleged onset date of disability.
At the second step, the ALJ found that Snyder had the severe medical impairments of
affective disorders, anxiety disorders, PTSD, and migraine headaches.
At the third step, the ALJ found that Snyder did not have an impairment or combination of
impairments that met or equaled a listed impairment. In reaching that conclusion, the ALJ stated
that he had “considered the claimant’s impairments under the provisions of listings 11.00
(Neurological Disorders) and found that the claimant’s conditions do not meet or medically equal
the criteria of the listed impairments.” Additionally, the ALJ found that “[t]he claimant does not
allege that she has an impairment of listing level severity, nor has she met her burden of presenting
medical evidence that supports such a finding.”
At the fourth step, the ALJ found that Snyder had the RFC to perform work at all exertional
levels, but that she was limited to performing simple, routine, repetitive tasks, without production
requirements, and only occasional interaction with the public, co-workers, and supervisors.
Additionally, the ALJ found that Snyder had to avoid even moderate exposure to bright lighting,
noise levels in excess of three, and concentrated exposure to fumes and odors. In support of this
determination, the ALJ discussed Snyder’s history of migraines and the various treatments she had
tried. In particular, the ALJ found that Snyder’s treatment notes consistently reported that she had
intact reflexes with no sensory or coordination loss. The ALJ reasoned that if Snyder’s
neurological impairment was as debilitating as claimed, her records would indicate some
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No. 22-5948, Snyder v. Comm’r of Soc. Sec.
diminishment of her reflexes. The ALJ also afforded “great weight” to Dr. Frey’s opinion because
Dr. Frey reviewed the entire record and concluded that Snyder did not have a “physical functional
impairment on a neurological basis.”
At the fifth step, the ALJ concluded that this RFC would allow Snyder to perform her past
relevant work as a coffee maker. Alternatively, the ALJ found that this RFC would permit Snyder
to perform the document preparer, photocopy machine operator, and gate attendant jobs identified
by the VE. The ALJ thus concluded that Snyder was not disabled under the Social Security
regulations and denied her application for disability insurance benefits.
The Appeals Council denied Snyder’s request to review the ALJ’s decision, making that
decision the final decision of the Commissioner. Snyder filed another timely complaint for judicial
review of the ALJ’s decision in district court. See 42 U.S.C. § 405(g). She argued that the ALJ’s
decision was not supported by substantial evidence because he (1) did not properly evaluate her
credibility, (2) violated the treating physician rule by not crediting the opinions of Dr. Johnathan
Smith, a neurologist who treated her headaches between 2013 and 2017, and (3) failed to consider
whether her headache disorder was medically equivalent to Listing 11.02 for epilepsy. The district
court rejected these arguments and affirmed the ALJ’s decision. Snyder raises the same three
arguments in this timely appeal.
A. Standard of Review
“Our review of the ALJ’s decision is limited to whether the ALJ applied the correct legal
standards and whether the findings of the ALJ are supported by substantial evidence.” Blakley v.
Comm’r of Soc. Sec., 581 F.3d 399, 405 (6th Cir. 2009). Substantial evidence exists “if a
reasonable mind might accept the relevant evidence as adequate to support a conclusion.” Id.
at 406 (cleaned up). We review de novo the district court’s conclusions on each issue. Id.-4-
No. 22-5948, Snyder v. Comm’r of Soc. Sec.
B. Analysis
1. Listing 11.02
Snyder first argues that the ALJ failed to consider whether her headache disorder was
medically equivalent to Listing 11.02 for epilepsy under Social Security Ruling 19-4p.
At the third step of the disability evaluation sequence, the ALJ must determine whether the
claimant’s medically determinable impairment meets or equals a listed impairment. A claimant
whose impairment or combination of impairments meets or equals a listed impairment is
conclusively disabled and entitled to benefits without any further need for the ALJ to complete the
remaining steps of the sequence. Sullivan v. Zebley, 493 U.S. 521, 532 (1990); Deaner v. Comm’r
of Soc. Sec., 840 F. App’x 813, 817 (6th Cir. 2020). An “impairment[] is medically equivalent to
a listed impairment . . . if it is at least equal in severity and duration to the criteria of any listed
impairment.” 20 C.F.R. § 404.1526(a). “A claimant can demonstrate that she is disabled because
her impairments are equivalent to a listed impairment by presenting ‘medical findings equal in
severity to all the criteria for the one most similar listed impairment.’” Foster v. Halter, 279 F.3d
348, 355 (6th Cir. 2001) (quoting Zebley, 493 U.S. at 531)).
Social Security Ruling 19-4p, 2019 WL 4169635 (Aug. 26, 2019), establishes the
Commissioner’s guidelines on evaluating primary headache disorders in disability claims. The
ruling identifies Listing 11.02 as “the most closely analogous listed impairment for an MDI
[medically determinable impairment] of a primary headache disorder.” Id. at *7. “While
uncommon,” the ruling states, “a person with a primary headache disorder may exhibit equivalent
signs and limitations to those detailed in listing 11.02 (paragraph B or D for dyscognitive seizures),
and we may find that his or her MDI(s) medically equals the listing.” Id.-5-
No. 22-5948, Snyder v. Comm’r of Soc. Sec.
Paragraph B of Listing 11.02 requires “[d]yscognitive seizures occurring at least once a
week for at least 3 consecutive months despite adherence to prescribed treatment.” 20 C.F.R.
pt. 404, subpt. P, app. 1, Listing 11.02(B) (citations omitted).1 Paragraph D requires
“[d]yscognitive seizures, occurring at least once every 2 weeks for at least 3 consecutive months
despite adherence to prescribed treatment” and a marked limitation in at least one area of
functioning. To determine whether a primary headache disorder is medically equivalent to
Listing 11.02, the Commissioner requires:
A detailed description from an AMS [acceptable medical source] of a typical
headache event, including all associated phenomena (for example, premonitory
symptoms, aura, duration, intensity, and accompanying symptoms); the frequency
of headache events; adherence to prescribed treatment; side effects of treatment (for
example, many medications used for treating a primary headache disorder can
produce drowsiness, confusion, or inattention); and limitations in functioning that
may be associated with the primary headache disorder or effects of its treatment,
such as interference with activity during the day (for example, the need for a
darkened and quiet room, having to lie down without moving, a sleep disturbance
that affects daytime activities, or other related needs and limitations).
SSR 19-4p, 2019 WL 4169635, at *7.
The ALJ did not specifically cite Listing 11.02 in his decision, but Snyder does not dispute
the ALJ’s finding that she did “not allege that she has an impairment of listing level severity[.]”
In any event, the ALJ stated that he had considered whether Snyder’s impairments met or equaled
the impairments under Listing 11.00. We are therefore satisfied that the ALJ evaluated whether
Snyder’s migraine headaches equaled Listing 11.02. See Forrest v. Comm’r of Soc. Sec., 591
F. App’x 359, 365 (6th Cir. 2014) (declining to remand the case to the ALJ for a further
1
“Dyscognitive seizures are characterized by alteration of consciousness without
convulsions or loss of muscle control. During the seizure, blank staring, change of facial
expression, and automatisms (such as lip smacking, chewing or swallowing, or repetitive simple
actions, such as gestures or verbal utterances) may occur.” 20 C.F.R. pt. 404, subpt. P, app. 1,
Listing 11.02(B) (citations omitted)
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No. 22-5948, Snyder v. Comm’r of Soc. Sec.
explanation of his step-three reasoning because the claimant did not argue at the evidentiary
hearing that he met a particular listing); Bledsoe v. Barnhart, 165 F. App’x 408, 411 (6th Cir.
2006) (holding that “[t]he ALJ did not err by not spelling out every consideration that went into
the step three determination”).
We conclude further that substantial evidence supports the ALJ’s determination that
Snyder’s migraine headaches did not equal Listing 11.02. As an initial matter, Snyder has not
directed us to a statement from an acceptable medical source that complies with SSR 19-4p, i.e.,
one that provides a detailed description of a typical migraine event, the side effects of her
medications, and, most importantly, an opinion concerning the limitations in functioning
associated with her migraines. In contrast, Dr. Frey stated that Snyder’s neurological impairments
did not cause any physical limitations.2 Another state-agency consultant, Dr. Sprague, stated that
Snyder was only mildly impaired in her ability to sustain concentration and attention. Other
substantial evidence, such as contemporaneous treatment notes, consultative examination reports,
and the ALJ’s assessment of Snyder’s demeanor during the evidentiary hearing, supported the
finding that Snyder was only moderately impaired in remembering, interacting with others,
maintaining concentration, persistence, and pace, and adapting or managing herself. See SSR
19-4p, 2019 WL 4169635, at *7 (providing that medical equivalence requires marked limitations
in these areas).
Consequently, we find no reversible error in the ALJ’s step-three analysis.
2
Snyder criticizes the ALJ’s reliance on Dr. Frey’s opinion and other medical evidence
showing that her reflexes were intact because she claimed disability based on migraine headaches
and not due to a physical impairment. But this evidence was relevant in determining whether
Snyder’s migraines caused limitations in physical functioning, see SSR 19-4p, 2019 WL 4169635,
at *7, and supported the ALJ’s step-three findings.
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No. 22-5948, Snyder v. Comm’r of Soc. Sec.
2. The ALJ’s Credibility Evaluation
Snyder next argues that the ALJ failed to properly evaluate her credibility. The term
“credibility” is no longer a part of the disability lexicon, however, because “subjective symptom
evaluation is not an examination of an individual’s character.” SSR 16-3p, 2016 WL 1119029,
at *1 (Mar. 16, 2016). Instead, the Commissioner “will consider an individual’s statements about
the intensity, persistence, and limiting effects of symptoms, and . . . evaluate whether the
statements are consistent with objective medical evidence and the other evidence.” Id. at *6. We
review an ALJ’s assessment of such statements under the substantial-evidence standard. Ulman
v. Comm’r of Soc. Sec., 693 F.3d 709, 713-14 (6th Cir. 2012).
Here, Snyder testified that, due to her symptoms, “she is incapable of working[.]” But the
ALJ found that statement to be inconsistent with the medical evidence and other evidence in the
record. Instead, the ALJ found that Snyder had the RFC to “perform a reduced range of work
activity,” so long as she limited herself to jobs that did not expose her to bright lighting, noise
levels more than level three, or concentrated levels of certain smells. And the ALJ supported these
findings by analyzing Snyder’s testimony about her migraine symptoms, her extensive treatment
history, and the opinions of three medical experts, which said that the evidence did not support
physical restrictions and limitations. The ALJ thus provided an adequate rationale and referred to
particular evidence in the record to support the weight it afforded to Snyder’s testimony when it
developed her RFC. Cf. Rogers v. Comm’r of Soc. Sec., 486 F.3d 234, 248 (6th Cir. 2007).
Accordingly, we conclude that the ALJ appropriately considered Snyder’s statements and
the evidence in the record when it developed her RFC.
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3. Treating Physician Rule
Lastly, Snyder argues that the ALJ violated the treating physician rule.
Snyder filed her claim for disability insurance benefits before the regulations were
amended in March 2017 to eliminate the “treating physician rule.” See 20 C.F.R. § 404.1520c
(2017). Under the treating physician rule, the opinion of a claimant’s treating physician is entitled
to controlling weight if it is “well-supported by medically acceptable clinical and laboratory
diagnostic techniques and is not inconsistent with other substantial evidence in the case record.”
Rogers, 486 F.3d at 242 (cleaned up). But
[i]f the Commissioner does not give a treating-source opinion controlling weight,
then the opinion is weighed based on the length, frequency, nature, and extent of
the treatment relationship . . . as well as the treating source’s area of specialty and
the degree to which the opinion is consistent with the record as a whole and is
supported by relevant evidence.
Gayheart v. Comm’r of Soc. Sec., 710 F.3d 365, 376 (6th Cir. 2013) (citing 20 C.F.R.
§ 404.1527(c)(2)-(6)). There is a rebuttable presumption “that the opinion of a treating physician
is entitled to great deference, its non-controlling status notwithstanding.” Rogers, 486 F.3d at 242
(citing SSR 96-2p, 1996 WL 374188, at *4 (“In many cases, a treating physician’s medical opinion
will be entitled to the greatest weight and should be adopted, even if it does not meet the test for
controlling weight.”)).
Snyder contends that the ALJ ignored Dr. Smith’s findings that her headaches caused
severe chronic pain, olfactory hallucinations, and visual disturbances. According to Snyder, had
the ALJ given controlling weight to these findings he would have been compelled to find that she
was credible about the intensity and persistence of her migraines. In support of this argument,
Snyder cites only a September 3, 2015, treatment record in which Dr. Smith noted, under the
heading “Active Problems,” that she had “chronic pain,” “headache,” “intractable chronic
migraine without aura and with status migrainosus” (i.e., that does not respond to treatment or lasts
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longer than 72 hours), “olfactory hallucination,” and “other visual disturbances.” We conclude
that her arguments do not demonstrate that the ALJ violated the treating physician rule.
First, Snyder’s arguments address whether her migraines were a severe impairment, and
the ALJ, consistent with Dr. Smith’s treatment notes, found that they were. Snyder’s case is
therefore distinguishable from Rogers, where we found that the ALJ violated the treating physician
rule by discounting the treating doctors’ opinions and findings showing that the claimant’s
fibromyalgia was a severe impairment. See Rogers, 496 F.3d at 244-46.
Second, Dr. Smith did not express an opinion that Snyder’s migraines resulted in any
functional limitations. See Masters v. Comm’r of Soc. Sec., 707 F. App’x 374, 379 (6th Cir. 2017)
(noting that the mere diagnosis of a severe impairment by a treating physician is insufficient by
itself to establish disability); accord Higgs v. Bowen, 880 F.2d 860, 863 (6th Cir. 1988) (per
curiam). So the claimed error could not have affected the ALJ’s determination of Snyder’s RFC.
We conclude therefore that the ALJ did not violate the treating physician rule.
Conclusion
We AFFIRM the district court’s judgment.
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