UNPUBLISHED

UNITED STATES COURT OF APPEALS

FOR THE FOURTH CIRCUIT

No. 15-1578

AMY SHARP,

Plaintiff - Appellant,

v.

CAROLYN W. COLVIN, Acting Commissioner, Social Security 

Administration,

Defendant - Appellee.

Appeal from the United States District Court for the Eastern 

District of Virginia, at Richmond. Henry E. Hudson, District 

Judge. (3:14-cv-00340-HEH)

Argued: September 20, 2016 Decided: November 14, 2016

Before KEENAN, FLOYD, and THACKER, Circuit Judges.

Affirmed by unpublished opinion. Judge Keenan wrote the 

opinion, in which Judge Floyd and Judge Thacker joined.

ARGUED: Bruce Knight Billman, Fredericksburg, Virginia, for 

Appellant. Elizabeth Wu, OFFICE OF THE UNITED STATES ATTORNEY, 

Richmond, Virginia, for Appellee. ON BRIEF: Dana J. Boente, 

United States Attorney, OFFICE OF THE UNITED STATES ATTORNEY, 

Alexandria, Virginia; Nora Koch, Acting Regional Chief Counsel, 

Victor Pane, Supervisory Attorney, Maija DiDomenico, Assistant 

Regional Counsel, Office of the General Counsel, SOCIAL SECURITY 

ADMINISTRATION, Philadelphia, Pennsylvania, for Appellee.
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Unpublished opinions are not binding precedent in this circuit.
3

BARBARA MILANO KEENAN, Circuit Judge:

Amy Sharp appeals from the district court’s judgment 

upholding a decision of the Social Security Administration 

(Social Security), which denied her application for disability 

insurance benefits. Citing our decision in Mascio v. Colvin, 

780 F.3d 632 (4th Cir. 2015), Sharp primarily argues that the 

Administrative Law Judge (ALJ) committed reversible error in 

using his assessment of her residual functional capacity 

(residual capacity) when evaluating her credibility and the 

opinion of her treating physician. 

Upon our review, we conclude that although the ALJ erred in 

certain aspects of his analysis, those errors were harmless 

because (1) the ALJ sufficiently explained his decision 

regarding the weight he accorded the treating physician’s 

opinion, and (2) substantial evidence supported the ALJ’s 

credibility determination. Accordingly, we affirm the district 

court’s judgment.

I.

We begin by describing the five-step sequential evaluation 

required by regulation that an ALJ must use in determining 

whether a claimant is disabled. See 20 C.F.R. § 404.1520(a)(4). 

The ALJ must assess whether: (1) the claimant has been engaged 

in “substantial gainful activity”; (2) the claimant has 
4

impairments that meet the regulations’ severity and duration 

requirements; (3) the impairments meet or equal an enumerated 

impairment; (4) the claimant is unable to perform her past 

relevant work; and (5) the claimant can perform other work, if 

she cannot perform her past relevant work. Id. Between steps 

three and four, the ALJ must assess the claimant’s residual 

capacity, or “the most” the claimant can do in a work setting 

despite her limitations. Id. §§ 404.1545(a)(1), 404.1520(a)(4). 

The claimant bears the burden of proof through step four, after 

which the burden shifts to the Commissioner of the Social 

Security Administration (Commissioner) to prove step five. 

Mascio, 780 F.3d at 635; Radford v. Colvin, 734 F.3d 288, 291 

(4th Cir. 2013).

If, at step one, the ALJ finds that the claimant has been 

working or, at step two, finds that the claimant’s medical 

impairments do not meet the severity and duration requirements, 

the ALJ must conclude that the claimant is not disabled. 20 

C.F.R. § 404.1520(a)(4)(i)-(ii). However, if the claimant meets

her burden at these first two steps, the ALJ considers step 

three, and either finds that the claimant is disabled because 

her impairment meets or equals an enumerated impairment, or the 

ALJ moves on to consider step four. Id. § 404.1520(a)(4)(iii). 

In step four, if a claimant can perform her past work given her 

residual capacity, the ALJ will conclude that the claimant is 
5

not disabled. Id. §§ 404.1520(a)(4)(iv), 404.1545(a)(5)(i). 

Otherwise, the ALJ proceeds to step five, which requires that 

the Commissioner prove that the claimant can perform work that 

“exists in significant numbers in the national economy,” and 

therefore is not disabled. Id. §§ 404.1560(c)(2), 

404.1520(a)(4)(v). 

In the present case, the ALJ concluded that Sharp did not 

meet her burden at step four regarding her ability to perform 

her past work. As we explain in detail below, the present case 

concerns the ALJ’s erroneous use of his residual capacity 

determination in evaluating Sharp’s credibility and the opinion 

of her treating physician. 

II.

Sharp was diagnosed with fibromyalgia between 2004 and 

2005. In September 2006, she began seeing Dr. Charles 

Gibellato, a physician who is board-certified in the fields of 

physical medicine and rehabilitation. Dr. Gibellato treated 

Sharp multiple times per year for a period exceeding five years, 

until May 2012. 

In March 2010, Sharp, then thirty-nine years old, filed a 

“protective” application for disability insurance benefits, 

alleging an onset date of September 12, 2008, which she later 

amended to July 29, 2010. Sharp asserted that she was disabled 
6

due to fibromyalgia, chronic fatigue, chronic lower back pain, 

and irritable bowel syndrome. 

Sharp presented her claim in a hearing before the ALJ in 

September 2012. She testified that she had widespread pain from 

her upper shoulders to her neck, lower spine, and hips, and 

behind her legs to her knees. She stated that her pain was 

unpredictable, and that its location and intensity varied.

Dr. Gibellato’s notes indicated that between October 2010 

and May 2012, Sharp’s symptoms were alleviated by medications 

and injections, but were aggravated by stress and activity. Dr. 

Gibellato’s notes also reflected that, between October 2010 and 

May 2012, Sharp reported: (1) that on a ten-point scale, her 

monthly average pain level ranged between six and eight, and (2) 

that in the twenty-four hour period prior to her appointments

with Dr. Gibellato, she generally had achieved between seventy 

percent and eighty percent relief of her symptoms, with one 

instance in which she reported fifty percent relief. 

In December 2010, Sharp completed a report for Social 

Security in which she stated that on “bad days,” she experienced 

high pain levels that prevented her from attempting household 

activities. She also related that on bad days, she needed a 

cane to get to the bathroom to use the toilet, and that she 

could not do much more on such days. Sharp could feed and dress 

herself, and on “good days,” she could perform light household 
7

chores, help her son with homework, prepare meals, shop for 

groceries, and walk outside with her dogs. According to Sharp, 

she had four or five good days each month.

Dr. Gibellato referred Sharp to Dr. Jennifer Wartella, a 

licensed clinical psychologist, to receive treatment for the 

psychological distress Sharp experienced in relation to her 

chronic pain and depression. Dr. Wartella treated Sharp in 

September 2011, and recorded that Sharp “tend[ed] to 

catastrophize her pain.”

After Sharp attended a session with a physical therapist in 

February 2012, the therapist’s notes indicated that Sharp 

demonstrated good potential for rehabilitation. The therapist 

recommended a treatment plan that included home exercise, heat, 

and ice. In August 2012, a different physical therapist noted 

that Sharp’s pain levels increased moderately throughout a 

sixty-minute physical performance test, and recommended a 

walking program or that she engage in stretching and 

conditioning. 

In a recorded statement in June 2012, Dr. Gibellato opined 

that in a work environment, Sharp would need to be able to take 

breaks, to change her position frequently, and to take narcotic 

medications while working. According to Dr. Gibellato, Sharp 

could not work in a cold environment, and could only perform 

work that involved a low level of stress. In September 2012, 
8

Dr. Gibellato further stated that while Sharp could perform 

sedentary work, it was unlikely that she could maintain a 

routine schedule. He explained that her symptoms would increase 

and have a cumulative effect over time, requiring her to be 

absent from her job after working for between two and four days.

Upon considering this evidence, the ALJ concluded that 

Sharp suffered from fibromyalgia, degenerative disc disease, 

degenerative joint disease, obesity, and depression. The ALJ 

further concluded that Sharp could perform sedentary work 

subject to certain limitations. The ALJ reasoned that while 

Sharp’s impairments were severe, they did not preclude her from 

performing “all sustained gainful activity.” The ALJ’s residual 

capacity assessment stated that Sharp

was limited to lifting and/or carrying 5 pounds 

frequently, and 10 pounds occasionally, sitting six 

hours in an eight hour workday, and standing/walking 

two hours in an eight hour work day. [Sharp] had to 

avoid jobs that required production quotas, and 

involved more than occasional overhead work . . . . 

Sharp was limited to work that allowed her to change 

positions once an hour, and work in an inside 

environment . . . . She was also limited to occasional 

interaction with peers, supervisors, and the public, 

and she was allowed to be absent from work about 10 

days a year.

Because the ALJ concluded that Sharp could perform her past work 

as a payroll clerk, the ALJ held that she was not disabled 

during the relevant time period. 
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In making this determination, the ALJ accorded little 

weight to Dr. Gibellato’s opinion that Sharp could not maintain 

a routine schedule. The ALJ concluded that Sharp’s “reported 

limitations were not supported by [Dr. Gibellato’s] office 

notes, nor were they consistent with” the ALJ’s residual 

capacity assessment. The ALJ also concluded that Sharp’s 

impairments reasonably could be expected to cause her alleged 

symptoms, but that her “statements concerning the intensity, 

persistence and limiting effects of [her] symptoms [we]re not 

credible,” in part because they were inconsistent with the ALJ’s 

residual capacity determination. The ALJ also stated that 

Sharp’s ability to function was not limited to the degree Sharp 

alleged because: (1) her subjective complaints were “not fully 

supported by the objective medical evidence”; (2) she had 

received “conservative” medical treatment; and (3) her admitted 

activities of daily living diminished her credibility regarding 

the frequency, severity, and limiting effects of her symptoms. 

After the Appeals Council denied Sharp’s request for review 

of the ALJ’s decision, Sharp filed a complaint in the district 

court seeking review of the Commissioner’s final decision 

denying her request for benefits. A magistrate judge 

recommended that the district court deny Sharp’s motion for 

summary judgment, grant the Commissioner’s motion for summary 

judgment, and affirm the ALJ’s final decision denying Sharp’s 
10

application for disability benefits. The district court adopted 

the magistrate judge’s report and recommendation, and upheld the

Commissioner’s determination. This appeal followed.

III.

A.

We first state the well-established standards governing our 

review of disability determinations. We must uphold the ALJ’s 

disability determination unless it was based on legal error or, 

in light of the whole record, is unsupported by substantial 

evidence. 42 U.S.C. § 405(g); Mascio, 780 F.3d at 634 (citation 

omitted); Meyer v. Astrue, 662 F.3d 700, 704 (4th Cir. 2011). 

The substantial evidence standard requires more than a 

scintilla, but may be less than a preponderance, of evidence. 

Hancock v. Astrue, 667 F.3d 470, 472 (4th Cir. 2012). We do not 

“reweigh conflicting evidence, make credibility determinations, 

or substitute our judgment for that of the [ALJ].” Johnson v. 

Barnhart, 434 F.3d 650, 653 (4th Cir. 2005) (per curiam) 

(alteration in original) (citation omitted). When conflicting 

evidence could lead reasonable minds to differ regarding whether 

a claimant is disabled, we defer to the ALJ’s disability 

determination. Hancock, 667 F.3d at 472 (citation omitted).
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B.

Sharp contends that the ALJ applied incorrect legal 

standards (1) in evaluating the weight to be given Dr. 

Gibellato’s opinion; and (2) in assessing Sharp’s credibility. 

Sharp argues that these errors were not harmless and require 

reversal of the ALJ’s disability determination. 

1.

Relying on our decision in Mascio, Sharp contends that the 

ALJ committed reversible error by according little weight to Dr. 

Gibellato’s opinion on the ground that the opinion conflicted 

with the ALJ’s residual capacity determination. In advancing 

this argument, Sharp acknowledges that the ALJ provided a second 

reason for assigning little weight to Dr. Gibellato’s opinion, 

namely, that Sharp’s “reported limitations were not supported by 

[Dr. Gibellato’s] office notes.” However, Sharp contends that 

this explanation is merely conclusory in nature, does not 

provide a sufficient basis on which to uphold the ALJ’s 

decision, and, because of its absence of detail, prevents us 

from engaging in meaningful appellate review. 

In addressing this issue, we first observe that an ALJ must 

accord controlling weight to a treating physician’s medical 

opinion regarding a claimant’s ability to work, if that opinion 

“is well-supported by medically acceptable clinical and 

laboratory diagnostic techniques and is not inconsistent with 
12

the other substantial evidence” in the record. 20 C.F.R. 

§ 404.1527(c)(2); Mastro v. Apfel, 270 F.3d 171, 178 (4th Cir. 

2001); see 20 C.F.R. § 404.1527(a)(2). Thus, “[b]y negative 

implication, if a physician’s opinion is not supported by 

clinical evidence or if it is inconsistent with other 

substantial evidence, it should be accorded significantly less 

weight.” Craig v. Chater, 76 F.3d 585, 590 (4th Cir. 1996); see 

generally 20 C.F.R. § 404.1527(c). Ultimately, the ALJ is not 

bound by a treating physician’s opinion that a claimant is 

disabled or unable to work, because that determination is 

reserved for the ALJ. See 20 C.F.R. § 404.1527(d)(1).

We agree with Sharp that the ALJ committed legal error in 

his analysis of the weight to be accorded to Dr. Gibellato’s 

opinion. As we have noted, the ALJ used his residual capacity 

assessment as one basis for assigning little weight to Dr. 

Gibellato’s opinion. We examined a similar analytical error in 

Mascio. The ALJ in that case had concluded that “the claimant’s 

statements concerning the intensity, persistence and limiting 

effects of [the claimant’s] symptoms [we]re not credible” 

because they were inconsistent with the ALJ’s own residual 

capacity assessment. Mascio, 780 F.3d at 639. 

We explained in Mascio that the ALJ’s reasoning conflicted 

with the agency’s regulations. Id. Those regulations require 

that an ALJ consider a claimant’s credibility before determining 
13

her residual capacity, instead of permitting the ALJ’s 

determination of residual capacity to serve as a basis for 

rejecting a claimant’s credibility. Id.

The ALJ in the present case similarly erred by concluding 

that Dr. Gibellato’s opinion merited little weight because it 

was inconsistent with the ALJ’s assessment of Sharp’s residual 

capacity. The regulations direct that an ALJ evaluate 

statements from treating physicians before, rather than after, 

determining a claimant’s residual capacity. 20 C.F.R. 

§ 404.1545(a)(3). Thus, the regulations do not allow an ALJ to 

consider whether a treating physician’s opinion is consistent 

with the ALJ’s residual capacity assessment when determining 

what weight to accord that physician’s opinion. See id.

§ 404.1527(c)(2). 

We further explained in Mascio, however, that an error of 

this nature may be deemed harmless when the ALJ has provided a 

sufficient alternate basis for his negative assessment of 

particular evidence. Mascio, 780 F.3d at 639. Therefore, we 

must now consider the sufficiency of the ALJ’s other stated 

reason for according less weight to Dr. Gibellato’s opinion. 

When, as here, an ALJ denies a claimant’s application, the 

ALJ must state “specific reasons for the weight given to the 

treating source’s medical opinion,” to enable reviewing bodies 

to identify clearly the reasons for the ALJ’s decision. Social 
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Security Ruling (SSR) 96-2p, 61 Fed. Reg. 34,490, 34,492 (July 

2, 1996). Based on our review of the record before us, we 

conclude that the ALJ provided a second, specific reason that is 

sufficient to afford such appellate review. 

The ALJ did not summarily conclude that Dr. Gibellato’s 

opinion merited little weight. Cf. Monroe v. Colvin, 826 F.3d 

176, 190-91 (4th Cir. 2016) (holding ALJ’s statement that “the 

objective evidence or the claimant’s treatment history did not 

support the consultative examiner’s findings” precluded 

meaningful review); Radford, 734 F.3d at 295; DeLoatche v. 

Heckler, 715 F.2d 148, 150 (4th Cir. 1983). Instead, the ALJ 

explained why he discredited Dr. Gibellato’s opinion, remarking 

that “the claimant’s reported limitations were not supported by 

[Dr. Gibellato’s] office notes.” While the ALJ did not cite 

specific pages in the record, his explanation relied on and 

identified a particular category of evidence. See generally 20 

C.F.R. § 404.1527(c)(2); SSR 96-2p.

Indeed, the record contains substantial evidence supporting 

the ALJ’s conclusion that Dr. Gibellato’s opinion did not merit 

controlling weight. Dr. Gibellato’s notes indicated that 

although Sharp’s symptoms were aggravated by stress and 

activity, medications and injections regularly provided Sharp 

relief. And, according to Dr. Gibellato’s notes, Sharp 

tolerated injections well and did not experience any 
15

complications as a result of these procedures. Furthermore, his 

notes indicated that Sharp often reported feeling relief of 

between seventy percent and eighty percent as a result of the 

treatments she received. These notes, considered as a whole, 

suggested that Sharp could manage her pain and maintain a 

routine work schedule, and were inconsistent with Dr. 

Gibellato’s contrary opinion. 

The ALJ also was entitled to consider whether Dr. 

Gibellato’s opinion was inconsistent with other material

evidence, such as (1) Dr. Wartella’s opinion that Sharp tended 

to “catastrophize” her pain, (2) the opinion of one physical 

therapist that Sharp had good potential for rehabilitation with 

use of a home exercise program, heat, and ice, and (3) the 

opinion of another physical therapist that Sharp’s problems 

could be alleviated in part by a walking program, or by 

stretching and conditioning. See 20 C.F.R. § 404.1527(c)(2). 

Based on this other evidence, the ALJ was not obligated to adopt 

Dr. Gibellato’s opinion about Sharp’s ability to work. See id.

§ 404.1527(d)(1). Moreover, we may not reweigh this evidence, 

and we must defer to the ALJ’s determination when, as here, 

conflicting evidence might lead reasonable minds to disagree 

whether Sharp was disabled. See Hancock, 667 F.3d at 472; 

Johnson, 434 F.3d at 653. 
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2.

We next address the ALJ’s determination that Sharp’s 

testimony lacked sufficient credibility. Sharp again relies on 

our decision in Mascio, asserting that the ALJ erred when he 

concluded that Sharp’s descriptions of the intensity, 

persistence, and limiting effects of her symptoms were not 

credible, because they were inconsistent with the ALJ’s own 

residual capacity determination. However, Sharp recognizes that 

the ALJ provided three additional reasons for his credibility 

determination, including that: (1) Sharp’s subjective complaints 

were “not fully supported by the objective medical evidence;” 

(2) Sharp’s treatment was “conservative;” and (3) Sharp’s 

admitted activities of daily living diminished her credibility 

regarding the frequency, severity, and limiting effects of her 

symptoms. Sharp nevertheless maintains that the three 

conclusions above are not supported by substantial evidence.

We agree with Sharp that the ALJ applied the same incorrect 

legal standard that we identified in Mascio, by using the ALJ’s 

own assessment of Sharp’s residual capacity to assess her 

credibility. See Mascio, 780 F.3d at 639. As we explained 

above, the regulations require that the ALJ consider the 

claimant’s credibility before determining her residual capacity, 

instead of permitting the ALJ’s residual capacity determination 

to serve as a basis for rejecting a claimant’s credibility. Id. 
17

Nevertheless, we again conclude that this error was harmless, 

because the ALJ provided sufficient additional reasons for 

concluding that Sharp’s statements about the extent of her 

limitations were not credible. See id. 

In determining the extent to which a claimant’s symptoms 

affect her capacity to perform basic work activities, the ALJ 

considers, among other factors, the claimant’s daily activities. 

20 C.F.R. § 404.1529(c)(3)-(4); see Johnson, 434 F.3d at 658. 

The ALJ also considers the claimant’s statements about the 

intensity, persistence, and limiting effects of her symptoms, 

and whether the functional limitations from those symptoms “can 

reasonably be accepted as consistent with the objective medical 

evidence* and other evidence.” 20 C.F.R. § 404.1529(c)(4). 

While we may not make our own credibility determinations, we may 

review whether substantial evidence supports an ALJ’s 

credibility determination. See Johnson, 434 F.3d at 658.

Here, the ALJ concluded that Sharp’s statements about the 

extent of her limitations were not fully supported by objective 

 * Objective medical evidence includes “medical signs and 

laboratory findings.” 20 C.F.R. § 404.1529(a). Medical signs 

are “anatomical, physiological, or psychological abnormalities 

which can be observed, apart from [the claimant’s] statements.” 

Id. § 404.1528(b). Laboratory findings are “anatomical, 

physiological, or psychological phenomena which can be shown by 

the use of medically acceptable laboratory diagnostic 

techniques.” Id. § 404.1528(c).
18

medical evidence. Dr. Gibellato’s notes indicated that Sharp’s 

symptoms were alleviated significantly with medications and 

injections, and that Sharp tolerated the injections well and did 

not experience any complications. When we consider these notes 

together with (1) Dr. Wartella’s opinion that Sharp tended to 

“catastrophize” the effects of her symptoms, and (2) the abovestated opinions and recommendations of the two physical 

therapists who evaluated Sharp, we conclude that substantial

evidence supports the ALJ’s conclusion that objective medical 

evidence undermined Sharp’s statements regarding the extent of 

her limitations. See Hancock, 667 F.3d at 472.

The ALJ further observed that Sharp’s medical care, which 

included injections, pain medication, and physical therapy, was 

“conservative.” The ALJ was permitted to make this 

determination that Sharp’s treatment was conservative, and that 

her course of treatment supported a conclusion that she was able 

to maintain a routine work schedule. See Wall v. Astrue, 561 

F.3d 1048, 1058-60, 1069 (10th Cir. 2009) (concluding that 

claimant’s treatment for pain, which included local anesthetic 

patches, Motrin, and cortisone injections in her back, was 

conservative). 

Finally, the ALJ concluded that Sharp’s reported daily 

activities were inconsistent with her alleged limitations. The 

ALJ recognized that Sharp’s pain was unpredictable and caused 
19

her difficulties. However, the ALJ also considered Sharp’s 

statements that on good days, Sharp could perform household 

chores and shop for groceries. We may not reweigh this 

evidence, make credibility determinations, or supplant the ALJ’s 

judgment with our own. Johnson, 434 F.3d at 654. Accordingly, 

viewing the record as a whole, we conclude that substantial 

evidence supports the ALJ’s credibility determination. See

Hancock, 667 F.3d at 472; Meyer, 662 F.3d at 704.

IV.

For these reasons, we affirm the district court’s judgment.

AFFIRMED