UNPUBLISHED

UNITED STATES COURT OF APPEALS

FOR THE FOURTH CIRCUIT

No. 11-1500

PAULA FELTON-MILLER,

Plaintiff - Appellant,

v.

MICHAEL J. ASTRUE, Commissioner of Social Security,

Defendant - Appellee.

Appeal from the United States District Court for the Eastern 

District of North Carolina, at New Bern. Louise W. Flanagan,

Chief District Judge. (2:10-cv-00005-FL)

Submitted: December 1, 2011 Decided: December 21, 2011

Before GREGORY, DAVIS, and DIAZ, Circuit Judges.

Affirmed by unpublished per curiam opinion.

David J. Cortes, ROBERTI, WITTENBERG, LAUFFER AND WICKER, 

Durham, North Carolina, for Appellant. Thomas G. Walker, United 

States Attorney, Amy C. Rigney, Special Assistant United States 

Attorney, Baltimore, Maryland, for Appellee.

Unpublished opinions are not binding precedent in this circuit.
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PER CURIAM:

Paula Felton-Miller appeals the district court’s order 

affirming the Commissioner of Social Security’s denial of her 

application for disability insurance benefits and supplemental 

security income. We must uphold the decision to deny benefits 

if the decision is supported by substantial evidence and the 

correct law was applied. 42 U.S.C. § 405(g) (2006); Johnson v. 

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

“Substantial evidence is such relevant evidence as a reasonable 

mind might accept as adequate to support a conclusion.” 

Johnson, 434 F.3d at 653 (internal quotation marks omitted). 

This court does not reweigh evidence or make credibility 

determinations in evaluating whether a decision is supported by 

substantial evidence; “[w]here conflicting evidence allows 

reasonable minds to differ,” we defer to the Commissioner’s 

decision. Id.

Felton-Miller “bears the burden of proving that [s]he 

is disabled within the meaning of the Social Security Act.” 

English v. Shalala, 10 F.3d 1080, 1082 (4th Cir. 1993) (citing 

42 U.S.C. § 423(d)(5) (2006)). The Commissioner uses a fivestep process to evaluate a disability claim. 20 C.F.R. 

§§ 404.1520(a)(4), 416.920(a)(4) (2011). Pursuant to this 

process, the Commissioner asks, in sequence, whether the 

claimant: (1) worked during the alleged period of disability; 
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(2) had a severe impairment; (3) had an impairment that met or 

equaled the severity of a listed impairment; (4) could return to 

her past relevant work; and (5) if not, whether she could 

perform any other work in the national economy. Id. The 

claimant bears the burden of proof at steps one through four, 

but the burden shifts to the Commissioner at step five. See

Bowen v. Yuckert, 482 U.S. 137, 146 n.5 (1987). If a decision 

regarding disability can be made at any step of the process, 

however, the inquiry ceases. See 20 C.F.R. §§ 404.1520(a)(4), 

416.920(a)(4).

Felton-Miller contends that the ALJ did not properly 

analyze her subjective complaints of pain. Relying on our 

decision in Craig v. Chater, 76 F.3d 585 (4th Cir. 1996), she 

argues that a claimant’s statements regarding the severity and 

limiting effects of pain are entitled to a presumption of 

credibility once the claimant has produced medical evidence 

demonstrating the existence of an impairment which could 

reasonably be expected to produce the pain alleged.

“[T]he determination of whether a person is disabled 

by pain or other symptoms is a two-step process.” Craig, 76 

F.3d at 594. First, the claimant must produce “objective 

medical evidence showing the existence of a medical impairment[] 

. . . which could reasonably be expected to produce the pain

. . . alleged.” Id.; 20 C.F.R. §§ 404.1529(a), 416.929(a) 
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(2011). Second, “the intensity and persistence of the 

claimant’s pain, and the extent to which it affects her ability 

to work, must be evaluated.” Craig, 76 F.3d at 595. The second 

step is analyzed using statements from treating and nontreating 

sources and from the claimant. 20 C.F.R. §§ 404.1529(a), 

416.929(a). Factors in evaluating the claimant’s statements 

include consistency in the claimant’s statements, medical 

evidence, medical treatment history, and the adjudicator’s 

observations of the claimant. See Social Security Ruling

(“SSR”) 96-7p, 1996 WL 374186, at *5-*8.

Craig lends no support to Felton-Miller’s position.1

 1 Felton-Miller identifies a host of other cases that she 

contends support the existence of a “great weight rule.” These 

cases recognize that subjective evidence may be entitled to 

great weight, but the cases do not rely on the finding at step 

one of the pain analysis. Rather, great weight is afforded to 

subjective evidence when it is either uncontradicted or 

supported by substantial evidence. See, e.g., Combs v. 

Weinberger, 501 F.2d 1361, 1362-63 (4th Cir. 1974) (“[W]e have 

held that subjective evidence is entitled to great weight, 

especially where such evidence is uncontradicted in the 

record.”) (internal quotation marks omitted).

 

Craig notes that step one of the pain analysis is focused solely 

“on establishing a determinable underlying impairment — a 

statutory requirement for entitlement to benefits.” Craig, 76 

F.3d at 594. Craig explains that, after the claimant crosses 

this threshold, “the intensity and persistence of the claimant’s 

pain, and the extent to which it affects her ability to work, 
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must be evaluated.” Id. at 595. The claimant’s own statements 

regarding her pain are not afforded any presumption; rather,

“[u]nder the regulations, . . . evaluation [of the claimant’s 

pain] must take into account not only the claimant’s statements 

about her pain, but also all the available evidence, including 

the claimant’s medical history, medical signs, and laboratory 

findings.” Id. (internal quotation marks omitted).

Felton-Miller contends the ALJ’s reasons for 

discrediting her subjective complaints at step two of the pain 

analysis were inaccurate and insubstantial. First, the ALJ 

found that Felton-Miller’s sarcoidosis has been well controlled 

with various medication regimens. Felton-Miller asserts that 

this statement is at odds with a treatment note that her 

symptoms were not well controlled with prednisone and subsequent 

notes that she stopped taking Plaquenil and methotrexate. 

However, we conclude that substantial evidence supports the 

ALJ’s conclusion because the record shows that, although FeltonMiller’s medication occasionally required adjustment, her

symptoms were successfully controlled at various times.

Second, Felton-Miller contends that the ALJ’s reliance 

on the absence of clinical signs of persistent joint 

inflammation, joint deformity, or limitation of joint motion is 

erroneous. She argues that sarcoidosis is a disease that, by 

definition, primarily involves a kind of inflammation, that she 
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at times presented and was assessed with joint problems, and 

that she was treated with anti-inflammatory drugs. However, 

medical conditions alone do not entitle a claimant to disability 

benefits; “[t]here must be a showing of related functional 

loss.” Gross v. Heckler, 785 F.2d 1163, 1166 (4th Cir. 1986). 

Accordingly, Felton-Miller’s sarcoidosis diagnosis, without 

more, does not establish that she suffers from any particular 

symptoms or limitations. Here, the ALJ acknowledged FeltonMiller’s treatment for joint, back, and muscle problems. 

However, the ALJ also determined that these problems were not 

persistent. Our review of the record leads us to conclude that 

the ALJ’s finding is supported by substantial evidence.

Third, Felton-Miller asserts that the ALJ erroneously 

relied on an irrelevant finding that her carpal tunnel syndrome 

was mild. We conclude that no such error occurred. In 

evaluating symptoms, including pain, an ALJ is to “consider all 

of the evidence presented.” 20 C.F.R. §§ 404.1529(c)(3), 

416.929(c)(3) (2011). Consideration of the limiting effects of 

Felton-Miller’s carpal tunnel syndrome led the ALJ to a residual 

functional capacity (“RFC”) assessment precluding her from 

performing tasks requiring the constant use of her hands. 

Fourth, the ALJ concluded that Felton-Miller’s 

degenerative disc disease was mild. Felton-Miller asserts that 

this finding is not supported by substantial evidence because 
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treatment notes indicate that she has a history of severe 

degenerative disc and joint disease. However, the ALJ reviewed 

the records Felton-Miller cites in addition to evidence that 

Felton-Miller enjoyed full strength, had no neurological 

deficits indicating nerve root compression, and had normal motor 

nerve function with no evidence of cervical myopathy. 

Additionally, contrary to Felton-Miller’s assertions, the ALJ’s 

finding that Felton-Miller’s degenerative disc disorder was a 

severe impairment at step two of the sequential evaluation does 

not contradict the ALJ’s conclusion that the disorder’s impact 

on her functioning was mild. Step two of the sequential 

evaluation is a threshold question with a de minimis severity 

requirement. See Bowen, 482 U.S. at 153-54; SSR 88-3c, 1988 WL 

236022.

Fifth, Felton-Miller argues that the ALJ erroneously 

rejected her pain testimony on the ground that she has not 

required aggressive measures for pain relief such as ongoing use 

of steroid medication. Felton-Miller has waived review of this 

issue by failing to raise it below. See Pleasant Valley Hosp. 

v. Shalala, 32 F.3d 67, 70 (4th Cir. 1994) (finding that 

appellant’s failure to raise issue during administrative hearing 

and before district court operates as waiver of appellate 

review).
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Turning to Felton-Miller’s argument that the ALJ’s RFC 

finding is not supported by substantial evidence because the ALJ 

is a layman and did not obtain an expert medical opinion, we 

conclude this argument is without merit.2

 2 Felton-Miller asserts that, because “bare medical findings 

are unintelligible to a lay person in terms of residual 

functional capacity, the ALJ is not qualified to assess residual 

functional capacity based on a bare medical record.” Gordils v. 

Sec. of Health & Human Servs., 921 F.2d 327, 329 (1st Cir. 

1990). Here, however, the nerve conduction test Felton-Miller 

identifies as too technical for a layman to interpret was 

interpreted in functional terms by the examining physician. 

Based on the test results, the doctor concluded that FeltonMiller had evidence of mild carpal tunnel syndrome but no other 

disorders.

 “[R]esidual functional

capacity is the most [a claimant] can still do despite [her]

limitations.” 20 C.F.R. §§ 404.1545(a), 416.945(a) (2011). It 

is an administrative assessment made by the Commissioner based 

on all the relevant evidence in the case record. See 20 C.F.R. 

§§ 404.1546(c), 416.946(c) (2011) (assigning responsibility of 

RFC assessment at hearing level to ALJ); SSR 96-8p (identifying 

RFC finding as administrative assessment and outlining criteria 

to be used). The ALJ was not required to obtain an expert 

medical opinion as to Felton-Miller’s RFC. The ALJ properly 

based his RFC finding on Felton-Miller’s subjective complaints, 

the objective medical evidence, and the opinions of treating, 

examining, and nonexamining physicians.
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Felton-Miller also argues that the ALJ did not make a 

valid mental RFC assessment because he did not apply the proper 

standards. In evaluating mental impairments, the ALJ employs a 

specific technique that considers four functional areas 

essential to the ability to work: activities of daily living; 

ability to maintain social functioning; concentration, 

persistence, and pace in performing activities; and 

deterioration or decompensation in work or work-like settings 

(Psychiatric Review Technique “PRT” findings). 20 C.F.R. 

§§ 404.1520a, 416.920a (2011). The ALJ’s decision must show the 

significant history and medical findings considered and must 

include a specific finding as to the degree of limitation in 

each of the four functional areas. 20 C.F.R. 

§§ 404.1520a(e)(4), 416.920a(e)(4) (2011). 

The ALJ concluded that Felton-Miller’s depressive 

disorder was a severe impairment at step two of the sequential 

process without discussion of the special technique. At step 

three, the ALJ listed the four functional areas and analyzed the 

impact of Felton-Miller’s depressive disorder on these areas. 

The decision discusses the medical records relevant to FeltonMiller’s treatment for depression in assessing her mental RFC. 

We conclude that the ALJ assessed Felton-Miller’s mental RFC in 

accordance with regulations.
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Based on the foregoing, we find that substantial 

evidence supports the agency decision, and we affirm the 

judgment of the district court. We dispense with oral argument 

because the facts and legal contentions are adequately presented 

in the materials before the court and argument would not aid the 

decisional process.

AFFIRMED