1

UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF OHIO

WESTERN DIVISION

ERIN THEOBALD, Case No. 1:17-cv-688

Plaintiff, Barrett, J.

Bowman, M.J.

v.

COMMISSIONER OF SOCIAL SECURITY,

Defendant.

REPORT AND RECOMMENDATION

Plaintiff Erin Theobald filed this Social Security appeal in order to challenge the 

Defendant’s finding that she is not disabled. See 42 U.S.C. §405(g). Proceeding through 

counsel, Plaintiff presents three claims of error for this Court’s review. As explained 

below, I conclude that the ALJ’s finding of non-disability should be AFFIRMED, because 

it is supported by substantial evidence in the record as a whole.

I. Summary of Administrative Record

In September 2013, Plaintiff filed an application for Disability Insurance Benefits 

(“DIB”), originally alleging disability beginning January 30, 2012, but subsequently 

amended to January 1, 2014.1 (Tr. 44). Plaintiff claims she is disabled primarily based 

upon bowel and bladder-related physical impairments, fibromyalgia, degenerative disc 

disease, and nerve damage in her upper extremities. After her claim was denied initially 

and upon reconsideration, Plaintiff requested an evidentiary hearing before an 

 

1At the hearing, counsel referred to Plaintiff’s Date Last Insured as September 30, 2014. (Tr. 44). However, 

based upon her SGA earnings record, the ALJ found Plaintiff remains insured through December 31, 2018. 

(Tr. 16).
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administrative law judge (“ALJ”). On April 5, 2016, she appeared with counsel and gave 

testimony before ALJ Billy Thomas; a vocational expert also testified. (Tr. 32-56). On 

June 16, 2016, ALJ Thomas issued an adverse written decision, concluding that Plaintiff 

was not disabled. (Tr. 14-25).

Plaintiff was 54 (closely approaching advanced age) on her disability onset date 

and had changed to the advanced age category, at 57 years old, at the time of the ALJ’s 

decision. She lives with her husband and elderly mother and has past relevant work as 

a medical transcriptionist which she performed at substantial gainful work (“SGA”) levels 

through 2013.

2

The ALJ specifically determined that Plaintiff suffers from the following severe 

impairments: “interstitial cystitis, irritable bowel syndrome, fibromyalgia, and degenerative 

disc disease of the thoracic and lumbar spine.” (Tr. 16). In addition to those severe 

impairments, the ALJ considered, but classified as non-severe, Plaintiff’s complaints of 

weakness in her hands, depression and anxiety. (Tr. 17). Pertinent to this appeal,3 the 

ALJ found that the evidence to support the testimony of upper extremity limitations to be 

“exceedingly limited, with the claimant receiving little documented treatment for symptoms 

associated with her carpel tunnel syndrome or ulnar neuritis.” (Id.) 

The ALJ next determined that none of Plaintiff’s impairments, either alone or in 

combination, met or medically equaled any Listing in 20 C.F.R. Part 404, Subpart P, 

Appendix 1, such that Plaintiff was entitled to a presumption of disability. (Tr. 19). 

 

2Plaintiff’s continued ability to work at SGA levels led her to amend her onset date to January 1, 2014 at 

the hearing.

3Plaintiff does not here challenge the determination that her mental impairments were not severe. 
3

Instead, the ALJ found that Plaintiff retained the residual functional capacity (“RFC”) to 

perform work at a sedentary level, subject to the following limitations:

[S]he must be permitted to change position every hour. She can never 

climb ladders, ropes, or scaffolds, can only occasionally stoop, and can only 

frequently kneel, crouch, crawl, and climb ramps and stairs. Moreover, she 

must avoid all exposure to hazards, extreme cold, and vibration.

(Tr. 19). Based upon the testimony of the vocational expert, the ALJ found that Plaintiff 

could perform her past job and therefore was not disabled. The Appeals Council denied 

review, leading Plaintiff to file this judicial appeal.

In her Statement of Errors, Plaintiff argues that the ALJ erred by: (1) failing to find 

severe upper extremity impairments and/or limitations; (2) assigning little weight to the 

opinion of a treating physician; and (3) negatively assessing Plaintiff’s credibility. 

II. Analysis

A. Judicial Standard of Review

To be eligible for benefits, a claimant must be under a “disability.” See 42 U.S.C. 

§1382c(a). Narrowed to its statutory meaning, a “disability” includes only physical or 

mental impairments that are both “medically determinable” and severe enough to prevent 

the applicant from (1) performing his or her past job and (2) engaging in “substantial 

gainful activity” that is available in the regional or national economies. See Bowen v. City 

of New York, 476 U.S. 467, 469-70 (1986). 

When a court is asked to review the Commissioner’s denial of benefits, the court’s 

first inquiry is to determine whether the ALJ’s non-disability finding is supported by 

substantial evidence. 42 U.S.C. § 405(g). Substantial evidence is “such relevant 

evidence as a reasonable mind might accept as adequate to support a conclusion.” 

Richardson v. Perales, 402 U.S. 389, 401 (1971) (additional citation and internal quotation 

omitted). In conducting this review, the court should consider the record as a whole. 
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Hephner v. Mathews, 574 F.2d 359, 362 (6th Cir. 1978). If substantial evidence supports 

the ALJ’s denial of benefits, then that finding must be affirmed, even if substantial 

evidence also exists in the record to support a finding of disability. Felisky v. Bowen, 35 

F.3d 1027, 1035 (6th Cir. 1994). As the Sixth Circuit has explained:

The Secretary’s findings are not subject to reversal merely because 

substantial evidence exists in the record to support a different conclusion.... 

The substantial evidence standard presupposes that there is a ‘zone of 

choice’ within which the Secretary may proceed without interference from 

the courts. If the Secretary’s decision is supported by substantial evidence, 

a reviewing court must affirm.

Id. (citations omitted). 

In considering an application for supplemental security income or for disability 

benefits, the Social Security Agency is guided by the following sequential benefits 

analysis: at Step 1, the Commissioner asks if the claimant is still performing substantial 

gainful activity; at Step 2, the Commissioner determines if one or more of the claimant’s 

impairments are “severe;” at Step 3, the Commissioner analyzes whether the claimant’s 

impairments, singly or in combination, meet or equal a Listing in the Listing of 

Impairments; at Step 4, the Commissioner determines whether or not the claimant can 

still perform his or her past relevant work; and finally, at Step 5, if it is established that 

claimant can no longer perform his or her past relevant work, the burden of proof shifts to 

the agency to determine whether a significant number of other jobs which the claimant 

can perform exist in the national economy. See Combs v. Com’r of Soc. Sec., 459 F.3d 

640, 643 (6th Cir. 2006); 20 C.F.R. §§404.1520, 416.920. 

A plaintiff bears the ultimate burden to prove by sufficient evidence that she is 

entitled to disability benefits. 20 C.F.R. § 404.1512(a). A claimant seeking benefits must 

present sufficient evidence to show that, during the relevant time period, she suffered an 
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impairment, or combination of impairments, expected to last at least twelve months, that 

left him unable to perform any job. 42 U.S.C. § 423(d)(1)(A). 

B. Plaintiff’s Claims of Error

1. Upper Extremity Impairments or Limitations

Plaintiff argues first that reversal is required because the ALJ failed to find any 

“severe” upper extremity impairments or limitations. She points to an EMG dated on July 

31, 2007, many years prior to her alleged 2014 onset of disability, in which an EMG test 

revealed “Incomplete Bilateral Ulnar Nerve Lesion[s]” at the elbows as well as a mild, right

median nerve lesion at the wrist. (Tr. 479-481). The same EMG study revealed many 

normal findings. For example, a needle EMG of several muscles in both upper extremities

was normal, including the cervical paraspinal muscles, reflecting no cervical 

radiculopathy. (Tr. 480; see also Tr. 709). The examining physician also found full range 

of motion in the shoulders, elbows and wrists, and noted a normal sensory examination, 

despite numbness in her wrists and moderate decrease in sensation in both hands. He 

diagnosed mild carpal tunnel syndrome for which he recommended surgical release on 

the right side. (Tr. 709). Plaintiff elected not to undergo surgery, choosing physical 

therapy instead and continuing to work full-time with software she purchased to reduce 

the amount of typing required in her job.

Plaintiff argues that the long-ago EMG test remains “probative evidence of the 

claimant’s upper extremity impairments.” (Doc. 5 at 3). She also points to a follow-up

examination in June 2015 in which an orthopedist, Dr. Thomas, recorded complaints of 

right elbow pain and numbness. However, Dr. Thomas noted that despite similar 

complaints back in 2007, she had responded favorably to conservative treatment at that 

time. “[S]he did very well until 6 to 8 months ago when symptoms recurred” and in 2015, 
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continued to work as a transcriptionist. (Tr. 705, emphasis added). She “attributed 

recurrence to sleeping position....” (Id.) On exam, Dr. Thomas found tenderness to 

palpation over the ulnar nerve, obvious subluxation of the ulnar nerve, and a positive 

Tinel’s sign consistent with ulnar neuritis on the right side. (Tr. 707). However, he also 

found intact strength, full range of motion, and a negative criss-cross test.4 (Tr. 707). In 

2015, he recommended only conservative treatment with Plaintiff to follow-up “if needed” 

in six weeks. (Tr. 51; see also Tr. 707). 

In August 2015, Plaintiff saw Christopher Diatte, M.D., a primary care physician 

who made normal findings including full strength throughout her extremities. (Tr. 716-

717).

As stated, Plaintiff worked as a transcriptionist at SGA levels from 2007 through 

2013. At the hearing, however, Plaintiff testified that she had “noticed quite a weakness 

in my hands with trying to maneuver opening a jar, buttoning something, zipping 

something,” and “feel like I drop things more.” (Tr. 44). Relevant to her past work, Plaintiff 

testified that she had “gradually” decreased the amount of typing she performed as a 

medical transcriptionist since her 2007 diagnoses and invested in Dragon software to 

reduce the amount of typing. (Tr. 44-45). 

Plaintiff complains that the ALJ erred at Step 2 of the sequential analysis by failing 

to find any “severe” upper extremity impairment, and further erred by failing to incorporate 

associated limitations into her RFC. I find no error. First, so long as an ALJ finds a 

claimant has at least one severe impairment at Step 2 and proceeds to the next steps of 

the sequential analysis, the “question of whether the ALJ characterized any other alleged 

 

4The criss-cross test measures the function of the ulnar nerve by having the patient cross his middle finger 

over the index finger. (Doc. 6 at 9, n.5, citing https://www.ncbi.nlm.nih.gov/pubmed/7430600).
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impairment as severe or not severe is of little consequence.” Pompa v. Com’r of Soc. 

Sec., 73 Fed. Appx. 801, 8032 (6th Cir. 2003); see also generally Maziarz v. Sec’y of 

HHS, 837 F.2d 240, 244 (6th Cir. 1987).

Second, as the ALJ explained, the only diagnostic testing – the 2007 EMG – was 

very remote in time to Plaintiff’s alleged onset date in 2014. Although some abnormalities 

were found in 2007, Plaintiff had full range of motion in her shoulders, elbows and wrists. 

(Tr. 709). Plaintiff’s complaints appear to have resolved with physical therapy in 2007. 

She chose not to pursue surgical release of her carpal tunnel syndrome and was able to 

continue working full-time as a transcriptionist notwithstanding her testimony that she 

purchased software to reduce the amount of typing required. For more than five years 

after her 2007 diagnoses up until October 2012 when she was evaluated by Dr. Portugal 

for complaints of intermittent back pain, Plaintiff made no hand complaints at all. And 

although she briefly complained of radiating numbness to Dr. Portugal (Tr. 370), he found 

no abnormalities in Plaintiff’s use of her hands or arms and declared Plaintiff to be 

“neurologically stable.” (Tr. 376-377). 

Records after her 2014 alleged onset date also do not support reversal of the ALJ’s 

determination that Plaintiff had no upper-extremity work-related limitations. For example, 

during a consultative examination in January 2014 by Dr. Ray, he found normal grip 

strength, manipulation ability, and sensation and opined that Plaintiff could “handle 

objects without difficulty.” (Tr. 446). In May 2014, Dr. Ross also noted no relevant 

abnormal findings. (Tr. 702-703). And in August 2015, Dr. Diatte again found full strength 

in Plaintiff’s extremities and no abnormalities. (Tr. 716-717). Notwithstanding Plaintiff’s 

isolated new complaint to Dr. Thomas in June 2015, he recommended only conservative 

treatment. In short, given the lack of evidence to support any arm or hand limitations
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whatsoever after Plaintiff’s alleged onset date and the consistent longitudinal evidence 

that supports the absence of such limitations, the ALJ’s decision not to include upper 

extremity limitations is substantially supported.

In her reply memorandum, Plaintiff argues that there is “no evidence that the ALJ 

considered” her alleged ulnar neuritis and mild right carpal tunnel syndrome at Steps 4 

and 5, because his only explicit discussion was at Step 2. (Doc. 8 at 1). Plaintiff implies 

(without citation to any evidence) that her decision not to pursue surgical intervention in 

2007 left the conditions unabated more than eight years later. To the contrary, even 

Plaintiff endorsed symptoms only “off and on” over the past 10 years. (Tr. 51). The 

records reflect resolution of Plaintiff’s symptoms in 2007, a single fleeting complaint in 

October 2012, and one additional complaint in June 2015. 

Plaintiff also points to her testimony that her physician advised her to type less

back in 2007, and that she complied with that advice by purchasing specialized software. 

However, the record as a whole strongly supports the ALJ’s determination that - whatever 

the status of Plaintiff’s previously diagnosed ulnar neuritis and/or carpal tunnel syndrome 

from 2007 until January 20145 - she had no associated limitations after her alleged onset 

of disability that precluded full-time work. In formulating a plaintiff’s RFC, there is no 

regulatory requirement that an ALJ separately discuss every non-severe impairment as 

to which the ALJ has found no work-related limitations. It is sufficient for the ALJ to state 

on the record that he has “considered all symptoms and the extent to which these 

symptoms can reasonably be accepted as consistent with the objective medical 

evidence,” as the ALJ did in this case. (Tr. 19, emphasis added). Accord Ditz v. Com’r 

 

5Many medical conditions including but not limited to conditions involving inflammation and nerve 

impingement resolve over time.
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of Soc. Sec., 2009 WL 440641 at *3 (E.D. Mich. Feb. 20, 2009) (no reversible error where 

ALJ found ulnar nerve compression to be non-severe and failed to include any related 

restrictions, despite some evidence that her doctor had advised her to avoid leaning on 

her elbow during a time when she was working).

2. Evaluation of a Treating Physician’s Opinions

Plaintiff’s second claim is that the ALJ erred by assigning little weight to the RFC 

opinions of the urogynecologist, Dr. Crisp, who began treating Plaintiff for her chronic and 

longstanding Interstitial Cystitis (“IC”) on May 30, 2013, seven months prior to her alleged 

disability onset date. A long-standing regulation regarding treating physicians provides: 

“If we find that a treating source’s opinion on the issue(s) of the nature and severity of 

your impairment(s) is well-supported by medically acceptable clinical and laboratory 

diagnostic techniques and is not inconsistent with the other substantial evidence in your 

case record, we will give it controlling weight.” 20 C.F.R. §404.1527(c)(2) (emphasis 

added); see also Warner v. Com’r of Soc. Sec., 375 F.3d 387, 390 (6th Cir. 2004); SSR 

96-2p.6 An ALJ must provide “good reasons” if he does not give controlling weight to the 

opinion of a treating physician. Id.

Before turning to Dr. Crisp’s opinions, it must be noted that the bulk of Plaintiff’s 

medical records concern her ongoing treatment for various bladder and bowel issues, 

including but not limited to IC. The ALJ summarized those records in chronological 

fashion, beginning in January 2014 and continuing through the date of his decision:

Medical documents recounting her history of treatment prior to her January 

2014 amended alleged onset date indicated her receipt of urethral dilations 

 

6A new rule set forth in 20 C.F.R. §404.1520c replaces the treating physician rule previously set forth in 20 

C.F.R. § 404.1527. However, based upon the date of Plaintiff’s DIB application in this case, the prior rule 

and related case law continue to apply. Accord, Glanz v. Com’r of Soc. Sec., 2018 WL 3722318 at n. 5 

(N.D. Ohio July 17, 2018).
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and hydrodistension, as well as bladder instillations during this period, as 

well as her complaints of frequent flares of right upper quadrant pain, 

nausea, and vomiting.... Notably, however, they also reveal the claimant’s 

submission to a December 2013 gallbladder removal that had reportedly 

relieved “70%” of these symptoms by April 2014....

Nevertheless, the claimant continued to undergo regular bladder 

instillations as her purported disability began, citing little relief from her 

symptoms of “constant” pelvis achiness and feelings of incomplete 

emptying during hits period.... By early April 2014, the claimant’s treating 

urologist recommended that she engage in an intensive course of weekly 

bladder instillations, physical therapy, and ongoing dietary maintenance.... 

Records...indicate her use of prescribed Percocet for pain, yet revealed 

that she was then only taking a half-tablet two times per day for pain....

(Tr. 21). 

The ALJ pointed out that as Plaintiff underwent treatment, she reported 

improvement, and by the end of April 2014, was walking 2 miles per day. (Tr. 21). 

Physical examination during the same timeframe “returned normal results, even as the 

claimant reported in May [2014] that she had struggled to comply with her dietary 

management over recent weeks.” (Id.) Plaintiff did not return to treatment again until 

December 2014, and subsequent records starting in March 2015 noted that she was 

“doing very well with instillations.” (Tr. 22; Tr. 884).7 She had no acute complaints or 

abnormal physical findings in 2015 treatment notes. By December 2015, treatment notes 

reflected she continued to do “very well” and had “not had a flare-up since July.” (Id.) 

More recent 2016 records similarly reflected that she continued to do “very well” in 

treatment, despite one flare triggered by “dietary cheats over the holiday.” (Tr. 22). 

Plaintiff’s physical exam was normal but vaginal Valium was prescribed to control 

 

7Treatment for IC includes lifestyle changes such as diet and exercise, bladder and bowel training, physical 

therapy, medicines, and bladder instillation. During an instillation, a physician administers a small amount 

of liquid medicine into the bladder with a catheter. The liquid is kept in the bladder for 10-15 minutes. See, 

e.g., https://www.niddk.nih.gov/health-information/urologic-diseases/interstitial-cystitis-painful-bladdersyndrome/treatment (accessed on 12/6/18).
11

reported pelvic and bladder spasms. Plaintiff reported that she continued to take no more 

than one Percocet per day, even though her prescription permits her up to two per day. 

(id.; see also Tr. 50, testimony that she “usually” takes some Percocet daily, but typically 

only a half pill twice per day).

Prior to evaluating Dr. Crisp’s opinions, the ALJ also considered Plaintiff’s daily 

activity level. Plaintiff reported that she spent her days with her grandchildren, lunching 

with friends, and grocery shopping. She continues to drive, performs household chores 

including laundry, making beds and doing dishes, and prepares meals for herself and her 

family. She is independent with personal grooming and hygiene, attends regular Bible 

studies, and worked at reduced levels throughout her purported disability period, with 

income reported through the end of 2015. She reported to Dr. Ray in 2014 that she enjoys 

reading, watching television, church outings, and watching movies, but has had to 

decrease the amount of biking and hiking she does. (Tr. 445).

Despite the fact that Dr. Crisp’s treatment notes reflect good results from her 

treatment of Plaintiff’s longstanding IC, Dr. Crisp completed a “Medical Assessment” form 

on March 17, 2016 in which she opined that Plaintiff’s IC causes work-preclusive 

limitations. For example, Dr. Crisp opined that Plaintiff could lift not more than 5 pounds, 

could stand for no more than 2 hours total (and not more than 20 minutes at a time), and 

also could sit for no more than 2 hours (and not more than 45 minutes at a time). She 

further opined that Plaintiff had reaching restrictions, would be off task 75-100% of the 

workday, and would miss “more than 10-15 days per month at least with others interrupted 

and requiring her to leave work.” (Tr. 721-726). 
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The ALJ reasonably rejected these extreme opinions, concluding that they were 

not entitled to controlling weight under applicable regulations because they were not wellsupported and were inconsistent with substantial evidence in the record:

The undersigned finds the limitations proposed by Dr. Crisp [to be] grossly 

overstated and at odds with the objective and treatment evidence made 

available – including, but not limited to, her own records of care that 

suggested the claimant’s favorable response to treatment. This source 

advised that the claimant could, inter alia, stand, sit, and walk for no more 

than a total combined 4 hours throughout a standard 8-hour workday, could 

never engage in balancing, crouching, or crawling activities, would miss 

more than 4 days of work each month, and would be off-task for 75-100% 

of the workday secondary to pain. Nothing in the available records supports 

such limitations, least of all the claimant’s self-reported activities of daily 

living, which far exceed Dr. Crisp’s suggested restrictions. Moreover, this 

professional offers no objective support for such drastic limitations, citing 

nothing aside from the claimant’s experience of subjective pain in support 

of her proposals. Finally, the undersigned notes that Dr. Crisp’s proposal 

that the claimant is limited to occasional reaching bears no rational 

relationship to any of the diagnosed impairments she treated.

In finding Dr. Crisp’s opinions entitled to little weight, the undersigned 

remains mindful of the requirements of the Regulations given her role as 

the claimant’s treating source. Initially, her opinion is not entitled to 

controlling weight, as her views remain unsupported by medically 

acceptable clinical and laboratory diagnostic techniques and stand 

inconsistent with the views of Dr. Ray and the state agency professionals. 

(Tr. 24).

Plaintiff maintains that because her IC “progressively worsened” over the years

since her original diagnosis in 2004, the ALJ should have given greater weight to Dr. 

Crisp’s RFC opinions. Plaintiff further argues that reversal is required because the ALJ 

failed to cite SSR 15-1p, which provides guidance on the evaluation of IC. Id., 2015 WL 

1292257 (S.S.A. March 18, 2015), as corrected at 2015 WL 1642778 (S.S.A. April 9, 

2015). However, an ALJ’s failure to cite to a social security ruling will never constitute 

reversible error, as “the ultimate issue is not whether the ALJ included a rote citation, but 

whether he complied with the regulatory scheme.” Cain v. Com’r of Soc. Sec., 2016 WL 
13

8604322, at *4 (S.D. Ohio, 2016), adopted at. 2017 WL 1102681 (S.D. Ohio, 2017); see 

also Allen v. Com’r of Soc. Sec., 2016 WL 6471092, at *3 (W.D. Mich., 2016). “‘While 

SSR’s do not have the force of law, they are an agency's interpretation of its own 

regulations and “entitled to substantial deference and will be upheld unless plainly 

erroneous or inconsistent with the regulation.’” Id., citing Kornecky v. Com'r of Soc. Sec., 

167 Fed. Appx. 496, 498 (6th Cir. 2006). Here, the record supports the ALJ’s evaluation 

of the degree of limitation caused by Plaintiff’s IC, including the intensity, persistence, and 

limiting effects of her condition. Contrast Chavis v. Astrue, 2012 WL 5306130 (S.D. Ohio 

Oct 26, 2012) (remanding where ALJ not only failed to cite SSR, but failed to include any 

discussion at all of plaintiff’s IC, including discussion of the intensity, persistence and 

limiting effects of that condition). 

SSR 15-1p makes clear that “we cannot determine that a person who has IC is 

disabled on the basis of his or her statement of symptoms alone.” Id., 2015 WL 1292257, 

at *2. Instead, SSR 15-1p explains that IC is a “complex genitourinary disorder involving 

recurring pain or discomfort in the bladder and pelvic region.” The ruling defines IC as: 

“An unpleasant sensation (pain, pressure, discomfort) perceived to be related to the 

urinary bladder, associated with lower urinary tract symptoms of more than six weeks 

duration, in the absence of infection or other identifiable causes.” Id. at *2. Symptoms 

vary in both kind and intensity. Id. As with fibromyalgia and other complex disorders, SSR 

15-1p emphasizes the need to evaluate longitudinal evidence “because symptoms, signs, 

and laboratory findings of IC may fluctuate in frequency and severity and may continue 

over a period of months or years.” Id. 

Longitudinal clinical records reflecting ongoing medical evaluation and 

treatment from the person's medical sources, especially treating sources, 

are extremely helpful in documenting the presence of any signs or 

laboratory findings, as well as the person's limitations over time. The 
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longitudinal record should contain medical observations, information about 

treatment, the person's response to treatment, and a detailed description of 

how the impairment affects the person's ability to function.

Id., at *5.

The ALJ’s opinion reflects careful analysis of the longitudinal evidence, which 

strongly supports the ALJ’s assessment of Plaintiff’s RFC and does not support Dr. 

Crisp’s extreme limitations concerning her IC condition or pain related to any other 

condition. Based on review of the same records, including records cited by Plaintiff on 

appeal, the undersigned finds no basis to disturb the ALJ’s substantially supported and 

appropriately articulated “good reasons” for rejecting Dr. Crisp’s unsupported opinions.

3. The ALJ’s Adverse Credibility Assessment

Plaintiff’s third claim challenges the ALJ’s adverse credibility determination. In 

formulating Plaintiff’s RFC, the ALJ found that Plaintiff’s “statements concerning the 

intensity, persistence and limiting effects of [her] symptoms are not entirely consistent 

with the medical evidence and other evidence in the record....” (Tr. 20). 

An ALJ’s credibility assessment must be supported by substantial evidence, but 

“an ALJ’s findings based on the credibility of the applicant are to be accorded great weight 

and deference, particularly since an ALJ is charged with the duty of observing a witness’s 

demeanor and credibility.” Walters v. Com’r of Soc. Sec., 127 F.3d 525, 531 (6th Cir. 

1997). Further, a credibility determination cannot be disturbed “absent a compelling 

reason.” Smith v. Halter, 307 F.3d 377, 379 (6th Cir. 2001). 

In addition to considering Plaintiff’s daily activity level in the context of evaluating 

Dr. Crisp’s opinions, the ALJ considered her activity level in assessing her subjective 

complaints. As stated, Plaintiff reported spending her days with her grandchildren, 

lunching with friends, and grocery shopping. She drives, performs a multitude of 
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household chores, is independent with personal grooming and hygiene, and attends 

regular Bible studies. She continued to work at an SGA level through 2013 and worked 

at reduced levels after that with income reported through the end of 2015. 

Plaintiff maintains that the fact that she continued to work at reduced levels after 

her alleged onset date should have been viewed as evidence that supported her claim 

rather than as undermining her subjective complaints. She argues that the record shows 

that she continued to try to work and only gradually decreased her hours until she no 

longer continue at an SGA level. However, the undersigned finds no basis for disturbing 

the credibility assessment in this case. Some facts, such as Plaintiff’s continued 

participation in work activity, are subject to more than one interpretation. While Plaintiff’s 

continued part-time employment could be interpreted as supporting her claim,

8 it was not 

unreasonable for the ALJ to view that same fact as undermining Plaintiff’s claim, 

particularly in light of many other inconsistencies in the record. 

In support of the adverse credibility finding, the ALJ pointed out many objective

testing and treatment records that did not fully support Plaintiff’s subjective complaints, 

including minimal evidence to support any impairment from fibromyalgia. (Tr. 20). Her 

lack of longitudinal treatment for her back condition and routinely normal physical exams 

likewise were inconsistent with her claim. (Id.) At a consultative examination in January 

2014, she advised she experienced only “intermittent” back pain that had successfully 

resolved with physical therapy and Robaxin. (Id.) Plaintiff testified at the hearing that she 

 

8Plaintiff’s testimony concerning the reasons for reducing her hours was equivocal. Although she testified 

in part that she reduced her hours due to alleged hand limitations, she also testified that the Dragon software 

allowed her to continue in her job, and that a dramatic reduction in her workload in 2012 was attributable 

to her employer losing business because medical transcription services were “taken in-house in the 

hospitals” at that time. (Tr. 44-45). 
16

could comfortably lift and carry no more than 5 to 10 pounds, sit for only 20-30 minutes 

and stand for the same time, and that she could not walk more than 30 minutes. However, 

the ALJ pointed out that her “recent testimony diverges from her previous statement to 

examining sources, where she advised of her ability to lift up to 20 pounds, sit for up to 

an hour, and walk for up to 2 miles at a time.” (Id.; see also Tr. 445). And both treating 

and examining sources “regularly remarked upon her normal range of motion and 

negative straight leg raises, as well as her full strength, sensation, and reflexes. (Tr. 21). 

With regard to pain management, Plaintiff visited a pain management specialist only once 

in 2014 and received mostly conservative care consisting of “as needed” Percocet and 

recommendations for heat, ice, and exercise. (Id.) 

Plaintiff’s assertion that she was disabled due to her bowel and bladder issues was 

inconsistent with records that reflected “70%” relief of her symptoms following December 

2013 gallbladder surgery, a few months prior to her alleged onset of disability. Although 

she continued to undergo regular bladder instillations as a form of treatment in 2014 and 

2015, citing “constant” pelvic achiness and feelings of incomplete emptying, the records 

do not support her allegations of extreme and disabling pain or functional limitations

beyond those determined by the ALJ. She was prescribed Percocet but took only a halftablet twice daily and advised her treating physicians of improvements after April 2014. 

The post-DLI evidence indicated she continued to do “very well” with treatments, with no 

more than “moderate” self-reported symptoms (Tr. 22). In fact, at her consultative 

examination in January 2014, she reported her pelvic and bladder-related pain was at no 

more than a “1 or 2” on a standard pain scale, with levels reaching only a “6” with acute 

flare-ups. (Id.; Tr. 444). 
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Many people suffer from chronic pain that does not disable them from all work. 

The ALJ’s decision not to fully credit Plaintiff’s complaints of disabling pain in this case is 

amply supported by the record.

III. Conclusion and Recommendation

For the reasons explained herein, IT IS RECOMMENDED THAT Defendant’s 

decision be AFFIRMED as supported by substantial evidence, and that this case be 

CLOSED. 

/s Stephanie K. Bowman 

Stephanie K. Bowman

United States Magistrate Judge
18

UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF OHIO

WESTERN DIVISION

ERIN THEOBALD, Case No. 1:17-cv-688

Plaintiff, Barrett, J.

Bowman, M.J.

v.

COMMISSIONER OF SOCIAL SECURITY,

Defendant.

NOTICE 

Pursuant to Fed. R. Civ. P 72(b), any party may serve and file specific, written 

objections to this Report and Recommendation (“R&R”) within FOURTEEN (14) DAYS of 

the filing date of this R&R. That period may be extended further by the Court on timely 

motion by either side for an extension of time. All objections shall specify the portion(s) of 

the R&R objected to, and shall be accompanied by a memorandum of law in support of 

the objections. A party shall respond to an opponent’s objections within FOURTEEN (14) 

DAYS after being served with a copy of those objections. Failure to make objections in 

accordance with this procedure may forfeit rights on appeal. See Thomas v. Arn, 474 U.S. 

140 (1985); United States v. Walters, 638 F.2d 947 (6th Cir. 1981).