NOT RECOMMENDED FOR PUBLICATION File Name: 22a0472n.06
Case No. 22-1397
UNITED STATES COURT OF APPEALS FOR THE SIXTH CIRCUIT FILED ) Nov 22, 2022 PATRICIA M. ROBINSON, DEBORAH S. HUNT, Clerk ) Plaintiff-Appellant, ) ) ON APPEAL FROM THE v. ) UNITED STATES DISTRICT ) COURT FOR THE EASTERN COMMISSIONER OF SOCIAL SECURITY, ) DISTRICT OF MICHIGAN Defendant-Appellee. ) ) OPINION )
Before: SUTTON, Chief Judge; COLE and THAPAR, Circuit Judges.
COLE, Circuit Judge. Patricia Robinson’s application for social security benefits was
denied after an administrative law judge found that she was not disabled within the meaning of the
Social Security Act. She subsequently filed suit in district court, asserting a lack of substantial
evidence to support the Commissioner of Social Security’s adverse decision. Based on a finding
of substantial evidence, the district court adopted the magistrate judge’s recommendation to deny
Robinson’s motion for summary judgment, grant the Commissioner’s motion for summary
judgment, and affirm the Commissioner’s decision. Because substantial evidence supports the
Commissioner’s evaluation of Robinson’s carpal tunnel syndrome and therefore the finding that
she is not disabled, we AFFIRM the district court’s decision. Case No. 22-1397, Robinson v. Commissioner of Soc. Sec.
I. BACKGROUND
Patricia Robinson applied for social security disability benefits due to hypothyroidism and
carpal tunnel syndrome in both hands. After her claim was initially denied, she requested a video
hearing before an Administrative Law Judge (“ALJ”).
Following Robinson’s hearing, the ALJ applied the governing five-step analysis and
ultimately found that Robinson was not disabled. See 20 C.F.R. § 404.1520(a)(4). Between steps
three and four of her analysis, the ALJ determined Robinson’s capacity for work, ultimately
concluding that Robinson could perform “light work,” subject to a range of limitations and
exceptions. In so finding, the ALJ considered Robinson’s symptoms and impairments, as well as
the medical evidence on the record, including at least seven separate sets of findings. Two of these
sets of findings are relevant to this appeal: those of a hand surgeon, Dr. Curtis Young, and an
occupational therapist, Delores Valtena. Considering Robinson’s age, education, and work
experience, a vocational expert testified that a similarly situated individual with the capacity for
light work would be able to perform the requirements of “representative occupations,” and
provided three examples encompassing 110,000 jobs in the national economy. Based on these
findings, the ALJ concluded that Robinson was not disabled within the meaning of the Social
Security Act, rendering her ineligible for benefits.
The Appeals Council summarily denied Robinson’s request for review of the ALJ’s
disability determination, making the ALJ’s decision the final decision of the Commissioner of
Social Security. Robinson filed suit in district court to challenge this decision. The parties cross-
moved for summary judgment. In his report and recommendation, the magistrate judge found that
the Commissioner’s decision was supported by substantial evidence on the record, and
recommended denying Robinson’s motion, granting the Commissioner’s motion, and affirming
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the Commissioner’s decision. Over Robinson’s objections, the district court adopted the
magistrate judge’s report and recommendation, therefore denying Robinson’s motion, granting the
Commissioner’s motion, and affirming the Commissioner’s decision.
Robinson timely appealed. On appeal, Robinson contends that because the ALJ failed to
follow the agency’s rules and regulations at multiple points, the Commissioner’s conclusion was
not supported by substantial evidence. We disagree.
II. ANALYSIS
A. Legal Standard
When the Appeals Council denied Robinson’s request for review of the ALJ’s decision,
that decision became the Commissioner’s final decision. 20 C.F.R. § 404.981. The district court
had jurisdiction to review such a final decision under 42 U.S.C. § 405(g). As the district court
entered its own final decision and Robinson timely appealed, we have appellate jurisdiction
under 28 U.S.C. § 1291 and can review the Commissioner’s decision—incorporating the ALJ’s
analysis and findings—under § 405(g).
We review the district court’s decision in a social security case de novo, Johnson v.
Commissioner of Soc. Sec., 652 F.3d 646, 648 (6th Cir. 2011), and our review is limited to whether
the Commissioner applied the correct legal standards and if the Commissioner’s decision was
based on substantial evidence. 42 U.S.C. § 405(g); Rogers v. Commissioner of Soc. Sec., 486 F.3d
234, 241 (6th Cir. 2007).
Substantial evidence is “more than a scintilla . . . but less than a preponderance; it is such
relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Rogers,
486 F.3d at 241 (quoting Cutlip v. Secretary of Health & Human Servs., 25 F.3d 284, 286 (6th Cir.
1994)). This is not a high threshold: it is reached so long as the Commissioner’s decision is
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supported by substantial evidence, even if the opposite conclusion is also supported by substantial
evidence, Crum v. Sullivan, 921 F.2d 642, 644 (6th Cir. 1990), and even if not every piece of
relevant medical evidence is discussed, Loral Defense Sys.-Akron v. NLRB, 200 F.3d 436, 452–53
(6th Cir. 1999) (citing NLRB v. Beverly Enterprises-Massachusetts, 174 F.3d 13, 26 (1st Cir.
1999)). Failing to follow agency rules and regulations constitutes a de facto lack of substantial
evidence regardless of a conclusion’s justification elsewhere in the record. Miller v. Commissioner
of Soc. Sec., 811 F.3d 825, 833 (6th Cir. 2016) (quoting Gentry v. Commissioner of Soc. Sec., 741
F.3d 708, 722 (6th Cir. 2014)).
B. Analysis
To be eligible for social security benefits, a claimant must be found to be “disabled” as
defined by the Social Security Act. 42 U.S.C. § 423(a)(1)(E). The Commissioner uses a five-step
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NOT RECOMMENDED FOR PUBLICATION File Name: 22a0472n.06
Case No. 22-1397
UNITED STATES COURT OF APPEALS FOR THE SIXTH CIRCUIT FILED ) Nov 22, 2022 PATRICIA M. ROBINSON, DEBORAH S. HUNT, Clerk ) Plaintiff-Appellant, ) ) ON APPEAL FROM THE v. ) UNITED STATES DISTRICT ) COURT FOR THE EASTERN COMMISSIONER OF SOCIAL SECURITY, ) DISTRICT OF MICHIGAN Defendant-Appellee. ) ) OPINION )
Before: SUTTON, Chief Judge; COLE and THAPAR, Circuit Judges.
COLE, Circuit Judge. Patricia Robinson’s application for social security benefits was
denied after an administrative law judge found that she was not disabled within the meaning of the
Social Security Act. She subsequently filed suit in district court, asserting a lack of substantial
evidence to support the Commissioner of Social Security’s adverse decision. Based on a finding
of substantial evidence, the district court adopted the magistrate judge’s recommendation to deny
Robinson’s motion for summary judgment, grant the Commissioner’s motion for summary
judgment, and affirm the Commissioner’s decision. Because substantial evidence supports the
Commissioner’s evaluation of Robinson’s carpal tunnel syndrome and therefore the finding that
she is not disabled, we AFFIRM the district court’s decision. Case No. 22-1397, Robinson v. Commissioner of Soc. Sec.
I. BACKGROUND
Patricia Robinson applied for social security disability benefits due to hypothyroidism and
carpal tunnel syndrome in both hands. After her claim was initially denied, she requested a video
hearing before an Administrative Law Judge (“ALJ”).
Following Robinson’s hearing, the ALJ applied the governing five-step analysis and
ultimately found that Robinson was not disabled. See 20 C.F.R. § 404.1520(a)(4). Between steps
three and four of her analysis, the ALJ determined Robinson’s capacity for work, ultimately
concluding that Robinson could perform “light work,” subject to a range of limitations and
exceptions. In so finding, the ALJ considered Robinson’s symptoms and impairments, as well as
the medical evidence on the record, including at least seven separate sets of findings. Two of these
sets of findings are relevant to this appeal: those of a hand surgeon, Dr. Curtis Young, and an
occupational therapist, Delores Valtena. Considering Robinson’s age, education, and work
experience, a vocational expert testified that a similarly situated individual with the capacity for
light work would be able to perform the requirements of “representative occupations,” and
provided three examples encompassing 110,000 jobs in the national economy. Based on these
findings, the ALJ concluded that Robinson was not disabled within the meaning of the Social
Security Act, rendering her ineligible for benefits.
The Appeals Council summarily denied Robinson’s request for review of the ALJ’s
disability determination, making the ALJ’s decision the final decision of the Commissioner of
Social Security. Robinson filed suit in district court to challenge this decision. The parties cross-
moved for summary judgment. In his report and recommendation, the magistrate judge found that
the Commissioner’s decision was supported by substantial evidence on the record, and
recommended denying Robinson’s motion, granting the Commissioner’s motion, and affirming
-2- Case No. 22-1397, Robinson v. Commissioner of Soc. Sec.
the Commissioner’s decision. Over Robinson’s objections, the district court adopted the
magistrate judge’s report and recommendation, therefore denying Robinson’s motion, granting the
Commissioner’s motion, and affirming the Commissioner’s decision.
Robinson timely appealed. On appeal, Robinson contends that because the ALJ failed to
follow the agency’s rules and regulations at multiple points, the Commissioner’s conclusion was
not supported by substantial evidence. We disagree.
II. ANALYSIS
A. Legal Standard
When the Appeals Council denied Robinson’s request for review of the ALJ’s decision,
that decision became the Commissioner’s final decision. 20 C.F.R. § 404.981. The district court
had jurisdiction to review such a final decision under 42 U.S.C. § 405(g). As the district court
entered its own final decision and Robinson timely appealed, we have appellate jurisdiction
under 28 U.S.C. § 1291 and can review the Commissioner’s decision—incorporating the ALJ’s
analysis and findings—under § 405(g).
We review the district court’s decision in a social security case de novo, Johnson v.
Commissioner of Soc. Sec., 652 F.3d 646, 648 (6th Cir. 2011), and our review is limited to whether
the Commissioner applied the correct legal standards and if the Commissioner’s decision was
based on substantial evidence. 42 U.S.C. § 405(g); Rogers v. Commissioner of Soc. Sec., 486 F.3d
234, 241 (6th Cir. 2007).
Substantial evidence is “more than a scintilla . . . but less than a preponderance; it is such
relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Rogers,
486 F.3d at 241 (quoting Cutlip v. Secretary of Health & Human Servs., 25 F.3d 284, 286 (6th Cir.
1994)). This is not a high threshold: it is reached so long as the Commissioner’s decision is
-3- Case No. 22-1397, Robinson v. Commissioner of Soc. Sec.
supported by substantial evidence, even if the opposite conclusion is also supported by substantial
evidence, Crum v. Sullivan, 921 F.2d 642, 644 (6th Cir. 1990), and even if not every piece of
relevant medical evidence is discussed, Loral Defense Sys.-Akron v. NLRB, 200 F.3d 436, 452–53
(6th Cir. 1999) (citing NLRB v. Beverly Enterprises-Massachusetts, 174 F.3d 13, 26 (1st Cir.
1999)). Failing to follow agency rules and regulations constitutes a de facto lack of substantial
evidence regardless of a conclusion’s justification elsewhere in the record. Miller v. Commissioner
of Soc. Sec., 811 F.3d 825, 833 (6th Cir. 2016) (quoting Gentry v. Commissioner of Soc. Sec., 741
F.3d 708, 722 (6th Cir. 2014)).
B. Analysis
To be eligible for social security benefits, a claimant must be found to be “disabled” as
defined by the Social Security Act. 42 U.S.C. § 423(a)(1)(E). The Commissioner uses a five-step
sequential evaluation process to determine whether a claimant has a qualifying disability.
20 C.F.R. § 404.1520(a)(4). When moving through the steps, “there are certain governing
standards to which an [agency] must adhere.” Rogers, 486 F.3d at 242. One such standard requires
the Commissioner to consider and assess the persuasiveness of any “medical opinion.” 20 C.F.R.
§ 404.1520c(a). A medical opinion is a “statement from a medical source about what you can still
do despite your impairment(s).” Id. § 404.1513(a)(2). A medical opinion is distinct from
“objective medical evidence,” id. § 404.1513(a)(1), or “other medical evidence,” id.
§ 404.1513(a)(3), neither of which are required to be considered or assessed for their
persuasiveness, see id. § 404.1520c(a). Even for a medical opinion, there is no requirement to
cite to every piece of evidence or conclusion, id. § 404.1520c(b)(1), nor must the agency give
controlling weight to any medical opinion, id. § 404.1520c(a).
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Central to Robinson’s appeal, between steps three and four of the evaluation process, the
Commissioner determined Robinson’s “residual functional capacity” (“RFC”). RFC measures the
most physical and mental work an individual can do despite any limitations or impairments.
20 C.F.R. §§ 404.1520(e), 404.1545(a)(1). The Commissioner then factored Robinson’s RFC into
its analysis at steps four and five, where he determined whether Robinson could perform any past
relevant work—step four—or other work considering her RFC as well as her age, education, and
work experience—step five. See 20 C.F.R. §§ 404.1520(a)(4), 404.1545(a)(5). While the
Commissioner stated his consideration of Robinson’s “complaints of [symptoms], the objective
findings in the record, and the opinion evidence” in coming to his RFC conclusion, Robinson
disagrees.
Specifically, Robinson argues that the Commissioner failed to consider and articulate the
persuasiveness of findings by one of her treating physicians, hand surgeon Dr. Young, which she
claims constituted a medical opinion, and that this evidence should have been considered either
way. Robinson further challenges the interpretation of a functional capacity evaluation by an
occupational therapist, Valtena, despite her evidence being contrary to the Commissioner’s
conclusion. We take these challenges in turn, ultimately concluding that the Commissioner’s
determination is supported by substantial evidence based on the proper legal standards.
1. Dr. Young’s Findings
First, Dr. Young’s findings do not constitute medical opinions, so the Commissioner was
not required to assess their persuasiveness or explain why the opinions were not adopted. See 20
C.F.R. § 404.1520c(a); Social Security Ruling, 1996 WL 374184, 96-8p (SSA 1996). Dr. Young
reiterated Robinson’s diagnosis of bilateral carpal tunnel syndrome and provided test results in
raw numbers. There is a difference between what Dr. Young provided—“[s]tatic two-point
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discrimination on the right is 7 mm in the thumb and 6 mm in the index through small finger”—
and what the Commissioner considered a medical opinion—“no limitation with low body mobility
. . ., ability to sit approximately 1-2 hours . . . [and] lift a maximum of 10 pounds.” The latter
describes “what [Robinson] can still do despite [her] impairment(s).” See 20 C.F.R.
§ 404.1513(a)(2).
Albeit tangential to Robinson’s “ability to perform physical demands of work activities”—
an ability relevant to medical opinions, see id. § 404.1513(a)(2)(i)—Dr. Young’s numbers
themselves do not describe what Robinson can or cannot do during the workday. The term
“medical opinion” cannot be understood to encompass every piece of information that describes
“what [a claimant] can still do” only after manipulation and interpretation with supplemental
evidence. See id. § 404.1513(a)(2). To do so would collapse the distinction between “medical
opinions” on one hand, and “laboratory findings” and “clinical findings” on the other—the latter
two of which need not be assessed, even if they could be interpreted as providing insight on work
activities. Whether Dr. Young’s findings instead constitute “objective medical evidence,” see id.
§ 404.1513(a)(1), or “other medical evidence,” see id. § 404.1513(a)(3), does not change that the
Commissioner was under no obligation to assess their persuasiveness.
Moreover, regardless of label, the Commissioner properly considered Dr. Young’s
findings. That the Commissioner did not specifically refer to Dr. Young’s grip strength and
discrimination testing is immaterial. See Loral Defense Sys., 200 F.3d at 452–53 (not all
information needs to be discussed); Dunlap v. Commissioner of Soc. Sec., 509 F. App’x 472, 476
(6th Cir. 2012) (unnecessary to discuss all evidence, particularly when the information is
considered implicitly). The Commissioner referenced Robinson’s June 2019 appointment with
Dr. Young, including Robinson’s rejection of the suggested treatment. And the Commissioner
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expressly acknowledged Robinson’s decreased bilateral strength and grip strength, demonstrated
by Dr. Young’s numerical findings. Such decreased strength factored into the Commissioner’s
determination to add limitations and exceptions to Robinson’s RFC, constituting adequate
consideration of the relevant medical evidence in compliance with the regulations. See 20 C.F.R.
§ 404.1520(e); Amir v. Commissioner of Soc. Sec., 705 F. App’x 443, 450 (6th Cir. 2017) (finding
no error in not discussing a specific test result when the broader pain measured by that test was
factored into limitations).
Combined, the Commissioner’s evaluation of Robinson’s carpel tunnel syndrome is
supported by substantial evidence, including evidence from Dr. Young, so the findings are
conclusive, see 42 U.S.C. § 405(g), and failure to further consider or assess Dr. Young’s test results
was not error.
2. Valtena’s Findings
While we do not find Robinson’s objections to the Commissioner’s alleged lack of or
improper consideration of Valtena’s reports waived, the Commissioner’s analysis of Robinson’s
carpal tunnel syndrome adequately addressed Valtena’s findings. As to the waiver point, we agree
with Robinson that while Valtena was not mentioned by name in Robinson’s objections to the
magistrate’s report, her tests and findings were, and these tests and findings go to her objection to
the Commissioner’s handle and finger finding. As such, this specific issue was properly preserved
for appellate review.
Unlike Dr. Young’s test results, Valtena provided a medical opinion regarding what tasks
Robinson can perform at work despite her impairments, so the Commissioner evaluated the
opinion’s persuasiveness. See 20 C.F.R.§ 404.1520c(a). In doing so, the Commissioner discussed
both Valtena’s ultimate conclusion—that Robinson can handle the physical demands of sedentary
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work—and her underlying findings—including test results and the reported variance in Robinson’s
lifting ability, ranging from zero to ten pounds depending on the height of the lift. This alone
satisfies the Commissioner’s burden as it relates to Valtena’s medical opinion. See 20 C.F.R.
§ 404.1520c(a)-(b)(1). That the evidence overall, including Valtena’s opinion, could support two
inconsistent conclusions regarding Robinson’s RFC—the capacity to perform sedentary work
versus light work—does not change that the Commissioner’s pick of the two is supported by
substantial evidence. See American Textile Mfrs. Inst., Inc. v. Donovan, 452 U.S. 490, 522–523
(1981) (quoting Consolo v. FMC, 383 U.S. 607, 620 (1966)).
In sum, the Commissioner’s decision that Robinson is not disabled as defined in the Social
Security Act complies with the agency’s regulations and is supported by substantial evidence.
III. CONCLUSION
For the foregoing reasons, we affirm the district court’s order adopting the magistrate
judge’s Report and Recommendation.
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