IN THE UNITED STATES DISTRICT COURT FOR THE MIDDLE DISTRICT OF PENNSYLVANIA
JENNIFER JACOBSEN, : Civil No. 1:25-CV-303 : Plaintiff, : : v. : : (Chief Magistrate Judge Bloom) FRANK BISIGNANO, : Commissioner of Social Security,1 : : Defendant. :
MEMORANDUM OPINION
I. Introduction Jennifer Jacobsen filed an application under Titles II and XVI of the Social Security Act for disability and disability insurance benefits and supplemental security income on July 7, 2022. Following a hearing before an Administrative Law Judge (“ALJ”), the ALJ found that Jacobsen was not disabled from her alleged onset date of August 31, 2021, through April 10, 2024, the date of the ALJ’s decision.
1 Frank Bisignano became the Commissioner of Social Security on May 7, 2025. Pursuant to Rule 25(d) of the Federal Rules of Civil Procedure and 42 U.S.C. § 405(g), Bisignano is substituted as the defendant in this suit. Jacobsen now appeals this decision, arguing that the ALJ’s decision is not supported by substantial evidence. After a review of the record,
and mindful of the fact that substantial evidence “means only—‘such relevant evidence as a reasonable mind might accept as adequate to support a conclusion,’”2 we conclude that substantial evidence supports
the ALJ’s findings in this case. Therefore, we will affirm the decision of the Commissioner denying this claim.
II. Statement of Facts and of the Case
Jennifer Jacobsen filed for disability and disability insurance benefits, as well as supplemental security income, alleging disability due to an aortic valve replacement, pace maker, heart issues since infancy, calcium buildup in her shoulders, migraines, low platelets, and issues with her cervical spine.3 Jacobsen was 50 years old at the time of her
amended alleged onset of disability and had no past relevant work.4
2 , 139 S. Ct. 1148, 1154 (2019). 3 Tr. 66. 4 Tr. 35. 2 The medical record regarding Jacobsen’s impairments5 revealed that Jacobsen treated for headaches and thrombocytopenia prior to the
amended onset date of disability.6 In August of 2021, Jacobsen had an oncology follow up appointment, at which time she complained of joint pain.7 It was noted that her thrombocytopenia was asymptomatic.8
Jacobsen was seen by Certified Registered Nurse Practitioner (“CRNP”) Gabriela Hogan in October for her annual examination.9 Jacobsen
reported she was in good health and was completing daily home workouts and gardening.10 CRNP Hogan noted Jacobsen’s chronic numbness and tingling in her bilateral arms, but Jacobsen did not want medications at
that time.11 A physical examination revealed normal range of motion, a negative Phalen’s test, and numbness and tingling in fingers after raising
5 While we have considered the records that pre-date the amended onset date of disability, our discussion focuses primarily on the records relevant to the alleged disability period. 6 Tr. 2060, 2065. 7 R. 2055. 8 Tr. 2058. 9 Tr. 2052-53. 10 Tr. 2053. 11 3 her arms above her head for one minute.12 Hogan ordered an x-ray of Jacobsen’s cervical spine.13 Hogan also noted Jacobsen’s history of two
prior heart surgeries and a chronic murmur and advised her to consider a cardiology consultation.14 In December of 2021, Jacobsen was diagnosed with severe aortic
stenosis, and she underwent an aortic valve replacement.15 She also required a post-operative pacemaker placement due to a heart block.16
She was discharged in stable condition after roughly one week in the hospital.17 At a two-week follow up appointment in January of 2022, Jacobsen reported she was doing well and planned to start cardiac
rehabilitation.18 In April, Jacobsen complained of dizziness and fatigue after she tried to do yardwork.19 At a later visit in April, Jacobsen reported arm
12 Tr. 2054. 13 Tr. 2055. 14 Tr. 2054. 15 Tr. 725 16 Tr. 665-66. 17 Tr. 669. 18 Tr. 1953. 19 Tr. 1937. 4 and shoulder pain, as well as weakness, that made her daily activities difficult.20 It was noted that Jacobsen’s migraines had decreased
significantly since starting Topamax.21 Regarding her shoulder pain, Jacobsen reported worsening pain that radiated down her bilateral arms.22 A physical examination revealed decreased range of motion in
both shoulders and an inability to reach behind her.23 CRNP Hogan ordered an x-ray, noting that she suspected adhesive capsulitis due to the
heart surgery and recommended a course of physical therapy.24 Jacobsen’s migraines were noted to be stable on Topamax.25 The x-ray of Jacobsen’s shoulders revealed adhesive capsulitis.26
Jacobsen began physical therapy in April and reported trouble reaching overhead and behind her back.27 She exhibited limited range of motion and impaired physical strength, which she reported decreased her
20 Tr. 1934. 21 22 Tr. 1935. 23 Tr. 1935-36. 24 Tr. 1936. 25 26 Tr. 2242-43. 27 Tr. 1931. 5 abilities to perform activities of daily living.28 At a follow up appointment with CRNP Hogan in June, Jacobsen reported that physical therapy was
decreasing her overall pain.29 Hogan assessed that the chronic adhesive capsulitis was improving and advised her to continue with physical therapy.30 In July, it was noted that Jacobsen missed a therapy
appointment due to sore shoulders after helping her father move.31 Physical therapy notes from August and September of 2022 indicate
that Jacobsen was still experiencing pain and decreased range of motion, but that therapy was slowly improving her condition.32 During this time, treatment notes indicated that Jacobsen engaged in activities such as
gardening and household chores.33 By October, Jacobsen completed physical therapy but reported that her condition did not totally improve, as she still had limited range of motion.34 She declined injections or a
prednisone taper at this visit, and she was advised to consult with
28 Tr. 1932. 29 Tr. 1925. 30 Tr. 1926. 31 Tr. 2437. 32 Tr. 2412 33 Tr. 2418, 2432. 34 Tr. 2410. 6 orthopedics.35 In November, Jacobsen continued to report difficulty reaching overhead, and her provider encouraged her to move and stretch
more frequently but noted that injections or surgery could be an option in the future.36 In April of 2023, Jacobsen presented for her annual examination
and follow up for her migraines and complaints of dizziness.37 Her migraines were noted to be stable with medications, and she inquired
about medical marijuana for complaints of anxiety.38 Jacobsen was noted to have low blood pressure, which CRNP Hogan explained was likely the cause of her dizzy spells and advised her to change positions slowly.39
However, Jacobsen did not want to take blood pressure medications.40 In June, Jacobsen continued to complain of dizziness and reported several episodes during which she felt a spinning sensation and lack of
balance.41 She also reported daytime fatigue and numbness in her
35 Tr. 2411. 36 Tr. 2401, 2403. 37 Tr. 2940. 38 Tr. 2941. 39 40 41 Tr. 2645. 7 hands.42 A physical examination at this visit was unremarkable.43 She further denied chest pain, shortness of breath, syncope, or leg swelling,
and it was noted her symptoms were consistent with vertigo.44 She was also referred to a sleep study for suspected sleep apnea, as well as to neurology for her complaints of numbness.45 At a cardiology follow up in
October, it was noted that Jacobsen never contacted neurology for a consultation.46
CRNP Hogan filled out a physical residual functional capacity assessment for Jacobsen in December of 2023.47 Hogan opined that Jacobsen could occasionally lift less than 10 pounds; could sit for four
hours and stand and/or walk for two hours in an eight-hour workday; would need to alternate sitting and standing; had no postural limitations; and was limited to occasional reaching overhead with both upper
extremities but not limited in reaching any other direction.48
42 43 Tr. 2647-48. 44 Tr. 2649. 45 46 Tr. 2676. 47 Tr. 3077-79. 48 8 It is against the backdrop of this record that an ALJ held a hearing on Jacobsen’s disability application on January 30, 2024.49 Jacobsen and
a Vocational Expert (“VE”) both appeared and testified at this hearing.50 Following this hearing, on April 10, 2024, the ALJ issued a decision denying Jacobsen’s application for disability benefits.51 The ALJ first
concluded that Jacobsen had not engaged in substantial gainful activity since her alleged onset date of August 31, 2021.52 At Step 2 of the
sequential analysis that governs disability claims, the ALJ found that Jacobsen suffered from severe impairments of aortic valve stenosis status post mechanical aortic valve replacement and pacemaker placement;
adhesive capsulitis; and cervical retrolisthesis.53 At Step 3, the ALJ concluded that none of these impairments met or equaled the severity of a listed impairment under the Commissioner’s regulations.54
Between Steps 3 and 4, the ALJ then concluded that Jacobsen:
49 Tr. 43-64. 50 51 Tr. 22-42. 52 Tr. 27. 53 54 Tr. 29-30. 9 [H]a[d] the residual functional capacity to perform light work as defined in 20 CFR 404.1567(b) and 416.967(b) except occasional balance, stoop, crouch, kneel, climb ramps and stairs, but never on ladders ropes or scaffolds; never crawl; occasional overhead reaching bilaterally, frequent other directions; limited to frequent exposure to temperature extremes of cold and heat, wetness, humidity, fumes, odors, dusts gases and poor ventilation, vibrations, and hazards including moving dangerous machinery and unprotected heights; must have the option to transfer positions with stand and walk intervals up to 30 minutes at a time, no limitation on sitting, not off tasks when transferring.55
In reaching this RFC determination, the ALJ considered the objective medical record detailed above, the medical opinion evidence, and Jacobsen’s reported symptoms. With respect to the medical opinion evidence, the ALJ considered the opinions of the state agency consultants, Drs. Manganiello and Cuozzo, and found these opinions generally persuasive.56 These providers opined that Jacobsen could perform a range of light work, including certain reaching limitations.57 Specifically, these providers found that Jacobsen could occasionally reach overhead and in different directions with her right upper extremity and
55 Tr. 30-31. 56 Tr. 34. 57 Tr. 72-76, 98-103. 10 frequently with her left.58 The ALJ found these particular limitations not entirely persuasive.59 Rather, the ALJ specifically found CRNP Hogan’s
limitation to occasional overhead reaching but no restrictions in reaching other directions to be more consistent with the record evidence, which showed improvement in Jacobsen’s shoulder functioning.60 Thus the ALJ
reasoned that she limited Jacobsen to occasional overhead reaching but frequent reaching in all other directions.61
With respect to the remainder of CRNP Hogan’s opinion, the ALJ found this opinion partially persuasive.62 The ALJ again reiterated that the opinion’s reaching limitations were consistent with Hogan’s own
treatment notes and other medical evidence in the record.63 However, the ALJ found Hogan’s more restrictive sitting, standing, walking, and lifting limitations to be inconsistent with the longitudinal medical record,
58 59 Tr. 34. 60 61 62 Tr. 35. 63 11 which included improvements with treatment, and with the state agency consultants’ opinions.64
With respect to Jacobsen’s symptoms, the ALJ found that Jacobsen’s statements concerning the intensity, persistence, and limiting effects of her impairments were not entirely consistent with the medical
evidence.65 Jacobsen testified that she could not work due to her history of heart surgeries, loss of energy, adhesive capsulitis, numbness in her
arms, and dizziness.66 While she testified she experienced lower back pain, she reported that she did not receive treatment.67 She further reported issues with her neck, which she treated with physical therapy.68
Jacobsen also testified to her history of migraines, which she reported were well controlled with medication.69 She further reported doing household chores but pacing herself due to her pain.70
64 65 Tr. 31-34. 66 Tr. 48-50. 67 TR. 52. 68 Tr. 54. 69 Tr. 58. 70 Tr. 59. 12 The ALJ ultimately found Jacobsen’s testimony to be inconsistent with the objective clinical findings.71 The ALJ recounted the objective
medical evidence, including unremarkable physical examinations as well as the documented symptoms of decreased range of motion and pain in Jacobsen’s bilateral shoulders.72 She also noted the records that
indicated Jacobsen’s pain and range of motion improved with treatment, including physical therapy.73 The ALJ further noted that Jacobsen
declined to follow some of the recommendations of her providers, such as orthopedic and neurology referrals, and that she was encouraged by her providers to be more active.74 Finally, the ALJ considered Jacobsen’s
activities of daily living, which included light housework and yardwork during the relevant period.75 Ultimately, the ALJ concluded that Jacobsen was not as limited as she alleged.
Having made these findings, the ALJ found at Step 4 that Jacobsen had no past relevant work but found at Step 5 that she could perform the
71 Tr. 31-34. 72 Tr. 31-34. 73 74 Tr. 32. 75 Tr. 33. 13 occupations of an order caller, office helper, and assembler of electrical accessories.76 Accordingly, the ALJ found that Jacobsen had not met the
stringent standard prescribed for disability benefits and denied her claim.77 This appeal followed. On appeal, Jacobsen argues that the ALJ’s
decision is not supported by substantial evidence because he failed to limit her to occasional reaching and failed to adequately consider her
symptoms. This case is fully briefed and is therefore ripe for resolution. For the reasons set forth below, we will affirm the decision of the Commissioner.
III. Discussion A. Substantial Evidence Review – the Role of this Court
This Court’s review of the Commissioner’s decision to deny benefits is limited to the question of whether the findings of the final decision- maker are supported by substantial evidence in the record.78 Substantial
76 Tr. 36. 77 Tr. 37. 78 42 U.S.C. §405(g); , 529 F.3d 198, 200 (3d Cir. 2008); , 901 F. Supp. 2d 533, 536 (M.D. Pa. 2012). 14 evidence “does not mean a large or considerable amount of evidence, but rather such relevant evidence as a reasonable mind might accept as
adequate to support a conclusion.”79 Substantial evidence means less than a preponderance of the evidence but more than a mere scintilla.80 A single piece of evidence is not substantial evidence if the ALJ
“ignores, or fails to resolve, a conflict created by countervailing evidence.”81 However, where there has been an adequately developed
factual record, substantial evidence may be “something less than the weight of the evidence, and the possibility of drawing two inconsistent conclusions from the evidence does not prevent [the ALJ’s decision] from
being supported by substantial evidence.”82 The court must “scrutinize the record as a whole” to determine if the decision is supported by substantial evidence.83
79 , 487 U.S. 552, 565 (1988). 80 , 402 U.S. 389, 401 (1971). 81 , 994 F.2d 1058, 1064 (3d Cir. 1993) (quoting , 710 F.2d 110, 114 (3d Cir. 1983)) (internal quotations omitted). 82 , 383 U.S. 607, 620 (1966). 83 , 304 F. Supp.2d 623, 627 (M.D. Pa. 2003). 15 The Supreme Court has explained the limited scope of our review, noting that “[substantial evidence] means—and means only—‘such
relevant evidence as a reasonable mind might accept as adequate to support a conclusion.’”84 Under this standard, we must look to the existing administrative record to determine if there is “‘sufficient
evidence’ to support the agency’s factual determinations.”85 Thus, the question before us is not whether the claimant is disabled, but rather
whether the Commissioner’s finding that he or she is not disabled is supported by substantial evidence and was based upon a correct application of the law.86
84 , 139 S. Ct. at 1154 (quoting , 305 U.S. 197, 229 (1938)). 85 86 , No. 3:12-CV-02417, 2014 WL 940205, at *1 (M.D. Pa. Mar. 11, 2014) (“[I]t has been held that an ALJ’s errors of law denote a lack of substantial evidence”) (alterations omitted); , 512 F. Supp. 913, 914 (W.D. Pa. 1981) (“The Secretary’s determination as to the status of a claim requires the correct application of the law to the facts”); , 900 F.2d 675, 678 (3d Cir. 1990) (noting that the scope of review on legal matters is plenary); , 901 F. Supp. 2d at 536 (“[T]he court has plenary review of all legal issues . . . .”). 16 When conducting this review, we must remain mindful that “we must not substitute our own judgment for that of the fact finder.”87 Thus,
we cannot re-weigh the evidence. Instead, we must determine whether there is substantial evidence to support the ALJ’s findings. In doing so, we must also determine whether the ALJ’s decision meets the burden of
articulation necessary to enable judicial review; that is, the ALJ must articulate the reasons for his decision.88 This does not require the ALJ
to use “magic” words, but rather the ALJ must discuss the evidence and explain the reasoning behind his or her decision with more than just conclusory statements.89 Ultimately, the ALJ’s decision must be
accompanied by “a clear and satisfactory explication of the basis on which it rests.”90
87 , 777 F.3d 607, 611 (3d Cir. 2014) (citing , 399 F.3d 546, 552 (3d Cir. 2005)). 88 , 220 F.3d 112, 119 (3d Cir. 2000). 89 , 577 F.3d 500, 504 (3d Cir. 2009) (citations omitted). 90 , 642 F.2d 700, 704 (3d Cir. 1981). 17 B. Initial Burdens of Proof, Persuasion, and Articulation for the ALJ
To receive disability benefits under the Social Security Act, a claimant must show that he or she is unable to “engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death, or which
has lasted or can be expected to last for a continuous period of not less than 12 months.”91 This requires a claimant to show a severe physical or
mental impairment that precludes him or her from engaging in previous work or “any other substantial gainful work which exists in the national economy.”92 To receive benefits under Title II of the Social Security Act,
a claimant must show that he or she is under retirement age, contributed to the insurance program, and became disabled prior to the date on which he or she was last insured.93
91 42 U.S.C. §423(d)(1)(A); 42 U.S.C. §1382c(a)(3)(A); 20 C.F.R. §§404.1505(a), 416.905(a). 92 42 U.S.C. §423(d)(2)(A); 42 U.S.C. §1382c(a)(3)(B); 20 C.F.R. §§404.1505(a), 416.905(a). 93 42 U.S.C. §423(a); 20 C.F.R. §404.131(a). 18 In making this determination, the ALJ follows a five-step evaluation.94 The ALJ must sequentially determine whether the
claimant: (1) is engaged in substantial gainful activity; (2) has a severe impairment; (3) has a severe impairment that meets or equals a listed impairment; (4) is able to do his or her past relevant work; and (5) is able
to do any other work, considering his or her age, education, work experience and residual functional capacity (“RFC”).95
Between Steps 3 and 4, the ALJ must also determine the claimant’s residual functional capacity (RFC). RFC is defined as “that which an individual is still able to do despite the limitations caused by his or her
impairment(s).”96 In making this assessment, the ALJ must consider all the claimant’s medically determinable impairments, including any non- severe impairments identified by the ALJ at step two of his or her
analysis.97 Our review of the ALJ’s determination of the plaintiff’s RFC
94 20 C.F.R. §§404.1520(a), 416.920(a). 9520 C.F.R. §§404.1520(a)(4), 416.920(a)(4). 96 , 220 F.3d at 121 (citations omitted); 20 C.F.R. § 404.1545(a)(1). 97 20 C.F.R. §§404.1545(a)(2), 416.945(a)(2). 19 is deferential, and that determination will not be set aside if it is supported by substantial evidence.98
The claimant bears the burden at Steps 1 through 4 to show a medically determinable impairment that prevents him or her from engaging in any past relevant work.99 If met, the burden then shifts to
the Commissioner to show at Step 5 that there are jobs in significant numbers in the national economy that the claimant can perform
consistent with the claimant’s RFC, age, education, and work experience.100 With respect to the RFC determination, courts have followed
different paths when considering the impact of medical opinion evidence on this determination. While some courts emphasize the necessity of medical opinion evidence to craft a claimant’s RFC, other courts have
taken the approach that “[t]here is no legal requirement that a physician have made the particular findings that an ALJ adopts in the course of
98 312 F.3d 113, 129 (3d Cir. 2002). 99 , 994 F.2d at 1064. 100 20 C.F.R. §§404.1512(f), 416.912(f); , 994 F.2d at 1064. 20 determining an RFC.”101 Additionally, in cases that involve no credible medical opinion evidence, courts have held that “the proposition that an
ALJ must always base his RFC on a medical opinion from a physician is misguided.”102 Given these differing approaches, we must evaluate the factual
context underlying an ALJ’s decision. Cases that emphasize the importance of medical opinion support for an RFC assessment typically
arise in the factual setting where well-supported medical sources have found limitations to support a disability claim, but an ALJ has rejected the medical opinion based upon an assessment of other evidence.103
These cases simply restate the notion that medical opinions are entitled to careful consideration when making a disability determination. On the other hand, when no medical opinion supports a disability finding or
when an ALJ relies upon other evidence to fashion an RFC, courts have routinely sustained the ALJ’s exercise of independent judgment based
101 , 174 F. App’x 6, 11 (3d Cir. 2006); 962 F. Supp. 2d 761, 778–79 (W.D. Pa. 2013). 102 , 129 F. Supp. 3d 209, 214–15 (W.D. Pa. 2015). 103 , 962 F. Supp. 2d at 778–79. 21 upon all the facts and evidence.104 Ultimately, it is our task to determine, considering the entire record, whether the RFC
determination is supported by substantial evidence.105 C. Legal Benchmarks for the ALJ’s Assessment of Medical Opinions For applications filed after March of 2017, the regulations require
ALJs to consider several factors to determine the persuasiveness of a medical opinion: supportability, consistency, relationship with the claimant, specialization, and other factors tending to support or
contradict a medical opinion.106 Supportability and consistency are the two most important factors, and an ALJ must explain how these factors were considered in his or her written decision.107 Supportability means
“[t]he more relevant the objective medical evidence and supporting explanations . . . are to support his or her medical opinion(s) . . . . the
more persuasive the medical opinions . . . will be.”108 The consistency
104 , 174 F. App’x 6; 129 F. Supp. 3d at 214– 15. 105 312 F.3d 113. 106 20 C.F.R. § 404.1520c(c). 107 20 C.F.R. §§ 404.1520c(b)(2), 416.920c(b)(2); , 615 F. Supp. 3d 308, 316 (E.D. Pa. 2022). 108 20 C.F.R. §§ 404.1520c(c)(1), 416.920c(c)(1). 22 factor focuses on how consistent the opinion is “with the evidence from other medical sources and nonmedical sources.”109
While there is an undeniable medical aspect to the evaluation of medical opinions, it is well settled that “[t]he ALJ – not treating or examining physicians or State agency consultants – must make the
ultimate disability and RFC determinations.”110 When confronted with several medical opinions, the ALJ can choose to credit certain opinions
over others but “cannot reject evidence for no reason or for the wrong reason.”111 Further, the ALJ can credit parts of an opinion without giving credit to the whole opinion and may formulate a claimant’s RFC based
on different parts of different medical opinions, so long as the rationale behind the decision is adequately articulated.112 On the other hand, in cases where no medical opinion credibly supports the claimant’s
allegations, “the proposition that an ALJ must always base his RFC on a medical opinion from a physician is misguided.”113
109 20 C.F.R. §§ 404.1520c(c)(2), 416.920c(c)(2). 110 , 667 F.3d 356, 361 (3d Cir. 2011). 111 , 994 F.2d at 1066. 112 , 191 F. Supp. 3d 429, 455 (M.D. Pa. 2016). 113 , 129 F. Supp. 3d at 214–15. 23 D. Legal Benchmarks for the ALJ’s Assessment of a Claimant’s Alleged Symptoms
When evaluating lay testimony regarding a claimant’s reported degree of pain and disability, the ALJ must make credibility determinations.114 Our review of those determinations is deferential.115 However, it is incumbent upon the ALJ to “specifically identify and
explain what evidence he found not credible and why he found it not credible.”116 An ALJ should give great weight to a claimant’s testimony “only when it is supported by competent medical evidence.”117 As the
Third Circuit has noted, while “statements of the individual concerning his or her symptoms must be carefully considered, the ALJ is not required to credit them.”118
114 577 F.3d 500, 506 (3d Cir. 2009). 115 116 , 777 F.3d 607, 612 (3d Cir. 2014) (citations omitted). 117 , 150 F. Supp. 3d 406, 415–16 (M.D. Pa. 2015) (citations omitted). 118 667 F.3d 356, 363 (3d. Cir. 2011) (referencing 20 C.F.R. §404.1529(a) (“statements about your pain or other symptoms will not alone establish that you are disabled”). 24 The Social Security Rulings and Regulations provide a framework for evaluating the severity of a claimant’s reported symptoms.119 Thus,
the ALJ must follow a two-step process: first, the ALJ must determine whether a medically determinable impairment could cause the symptoms alleged; and second, the ALJ must evaluate the alleged symptoms
considering the entire administrative record.120 Symptoms such as pain or fatigue will be considered to affect a
claimant’s ability to perform work activities only if medical signs or laboratory findings establish the presence of a medically determinable impairment that could reasonably be expected to produce the alleged
symptoms.121 During the second step of this assessment, the ALJ must determine whether the claimant’s statements regarding the intensity, persistence, or limiting effects of his or her symptoms are substantiated
considering the entire case record.122 This includes, but is not limited to, medical signs and laboratory findings; diagnoses; medical opinions
119 20 C.F.R. §§ 404.1529, 416.929; SSR 16–3p. 120 SSR 16-3p. 121 20 C.F.R. §§ 404.1529(b), 416.929(b); SSR 16–3p. 122 20 C.F.R. § 404.1529(c), 416.929(c); SSR 16–3p. 25 provided by treating or examining sources and other medical sources; and information regarding the claimant’s symptoms and how they affect his
or her ability to work.123 The Social Security Administration recognizes that individuals may be limited by their symptoms to a greater or lesser extent than other
individuals with the same medical impairments, signs, and laboratory findings.124 Thus, to assist in the evaluation of a claimant’s subjective
symptoms, the Social Security Regulations set forth seven factors that may be relevant to the assessment of the claimant’s alleged symptoms.125 These factors include: the claimant’s daily activities; the “location,
duration, frequency, and intensity” of the claimant’s pain or symptoms; the type, dosage, and effectiveness of medications; treatment other than medications; and other factors regarding the claimant’s functional
limitations.126
123 124 SSR 16-3p. 125 20 C.F.R. §§ 404.1529(c)(3), 416.929(c)(3). 126 26 E. The ALJ’s Decision is Supported by Substantial Evidence.
Our review of the ALJ’s decision denying an application for benefits is significantly deferential. Our task is simply to determine whether the ALJ’s decision is supported by substantial evidence in the record; that is “only— ‘such relevant evidence as a reasonable mind might accept as
adequate to support a conclusion.’”127 Judged against this deferential standard of review, we conclude that substantial evidence supported the
ALJ’s decision in this case. The plaintiff first asserts that the ALJ’s decision is not supported by substantial evidence because the RFC limited her to occasional
overhead reaching and frequent reaching in other directions, rather than occasional reaching in all directions.128 Jacobsen asserts that the medical evidence supported a limitation to occasional reaching, and that the ALJ
failed to explain her rationale for the limitation to frequent reaching.129 She further argues that this error requires remand because a limitation
127 , 139 S. Ct. at 1154. 128 Doc. 16 at 7-10. 129 27 to occasional reaching would have eroded the occupations identified by the VE at the hearing.130
We find this argument particularly unavailing, as the ALJ’s decision clearly and explicitly explained why the ALJ limited Jacobsen to occasional overhead reaching and frequent reaching in other directions.
The decision first recounted the medical records concerning Jacobsen’s shoulder impairments, including the findings of decreased range of
motion and difficulty raising her arms. The ALJ also noted treatment records that indicated physical therapy was improving Jacobsen’s condition. Further, the ALJ discussed the medical opinions and
explained why she adopted certain limitations regarding Jacobsen’s reaching capabilities. She explained that the state agency consultants’ opinions were not entirely persuasive, but that she found CRNP Hogan’s
limitations to be supported by Hogan’s treatment notes and the remainder of the objective evidence.131 Thus, the ALJ’s decision clearly
130 131 The plaintiff’s argument that no medical opinion supports the RFC’s reaching limitations is particularly disingenuous, since it was the plaintiff’s own treating provider, CRNP Hogan, that opined that 28 explains the basis for these reaching limitations and is supported by the medical evidence in the record. While the plaintiff appears to rely on her
subjective symptoms to demonstrate that she was more limited, as we will explain, the ALJ found the plaintiff’s testimony not entirely credible. Accordingly, we find no error with the ALJ’s RFC limitation.
Further, the plaintiff’s contention that a limitation to occasional reaching would have eroded the occupations identified by the VE is
explicitly belied by the hearing transcript. The ALJ posed two light work hypotheticals to the VE that included the limitation to occasional overhead reaching and frequent reaching in other directions, and the VE
identified three occupations that the individual could perform, including an order caller, merchandise marker, and cafeteria attendant.132 After posing an additional hypothetical requiring a sit/stand option, the VE
testified that only the order caller position remained but identified other light work jobs that were available, such as an office helper and electrical
Jacobsen could occasionally reach overhead but had no limitations in reaching other directions. 132 Tr. 61. 29 accessories assembler.133 The ALJ then asked if those occupations would remain if the individual was limited to occasional lateral and forward
reaching with the right upper extremity, to which the VE responded those jobs would remain.134 While the plaintiff points out that the three jobs identified requiring “frequent reaching” in the DOT’s definition, the
VE further explained at the hearing that the DOT does not address overhead reaching or reaching certain directions, and that the testimony
was based on her experience.135 Counsel did not ask any questions of the VE or object to the VE’s experience. Given this testimony by the VE, we find the plaintiff’s argument
regarding her reaching limitations to be wholly without merit. Accordingly, because we find no error with the RFC determination, a remand is not required.
The plaintiff also contends that the ALJ erred in evaluating her subjective testimony by relying on her ability to perform some daily activities, improvement in her symptoms with treatment, and her
133 Tr. 61-62. 134 Tr. 62. 135 Tr. 63. 30 providers’ recommendations to stay active.136 At the outset, we note that a claimant’s daily activities and effects of treatment are factors that,
pursuant to the regulations, are relevant to the ALJ’s consideration of a claimant’s symptoms.137 Moreover, as we have explained, the ALJ thoroughly discussed and considered the objective medical evidence from
the relevant period, including the medical opinion evidence, which indicated Jacobsen’s impairments improved with treatment. While the
plaintiff would have us reweigh the evidence in her favor, we are prohibited from doing so.138 Given that the ALJ considered all the evidence and adequately
explained the decision for including or discounting certain limitations as established by the evidence, we find no error with the decision. Therefore, under the deferential standard of review that applies to
136 Doc. 16 at 11-14. 137 20 C.F.R. §§ 404.1529(c)(3), 416.929(c)(3); , , 421 F. App'x 184, 190 (3d Cir. 2011) (finding no error where the ALJ considered the claimant’s activities of daily living and found the claimant not entirely credible) (nonprecedential); , 2015 WL 7351583, at *12 (M.D. Pa. Nov. 20, 2015) (affirming decision where the ALJ considered effectiveness of treatment to conclude the claimant was less than credible). 138 , 777 F.3d at 611. 31 appeals of Social Security disability determinations, we conclude that substantial evidence supported the ALJ’s evaluation of this case, and this
decision will be affirmed. IV. Conclusion For the foregoing reasons, the decision of the Commissioner in this
case will be affirmed, and the plaintiff’s appeal denied. An appropriate order follows.
Submitted this 27th day of February 2026.
Daryl F. Bloom Chief United States Magistrate Judge