UN PUBLISHED
UNITED STATES COURT OF APPEALS FOR THE FOURTH CIRCUIT

No. 22

- 175 9

PATRICIA DENISE CUMMINGS,
Plaintiff

– Appellant,

v. COMMISSIONER OF SOCIAL SECURITY,
Defendant

– Appellee.

Appeal from the United States District Court for the District of Maryland, at Baltimore

. Beth P. Gesner, Magistrate Judge. ( 1:20

- cv - 03530

- BPG )

Submitted : November 9, 2023 Decided: December 28, 2023

Before THACKER and QUATTLEBAUM , Circuit Judge s, and MOTZ, Senior Circuit Judge.

Affirmed by un published per curiam opinion

.
ON BRIEF: Andrew N. Sindler, LAW OFFICES OF ANDREW N SINDLER, LLC, Severna Park, Maryland, for Appellant. Brian C. O’Donnell, Associate General Counsel, Stephen Giacchino, Supervisory Attorney, William Feldman, David N. Mervis, Special Assistant United States Attorney, Office of the General Counsel, SOCIAL SECURITY ADMINISTRATION, Baltimore, Maryland; Erek L. Barron, United States Attorney, OFFICE OF THE UNITED STATES ATTORNEY, Baltimore, Maryland, for Appellee.

Unpublished opinions are not binding precedent in this circuit. USCA4 Appeal: 22-1759 Doc: 26 Filed: 12/28/2023 Pg: 1 of 62 PER CURIAM: Patricia Cummings applied for social security benefits in 2014 , claiming she was unable to work due to several physical and mental impairments. An administrative law judge ( “ ALJ ” ) held a hearing and denied her claim in 201 7 , but t he district court vacated
the decision and remanded for further consideration of Cummings’s hand impairments.
Another ALJ held a new hearing on remand and a lso found that Cummings was not
d isabled

. This time, the district court upheld the decision. For the reasons that follow, w e
affirm.

I. The Social Security Administration (“the Agency”) uses a five

- step process to
evaluate whether someone is disabled under the Social Security Act . 20 C.F.R. § 404.1520(a)(4). The first three steps ask “ ( 1) whether the claimant is working; (2) if not,
whether she has a ‘ severe impairment ’ ; and (3) if she does, whether the impairment ‘ meets or equals a listed impairment. ’” Patterson v. Comm’r of Soc. Sec. Admin. , 846 F.3d 656,
65 9 (4th Cir. 2017) (quoting 20 C.F.R. § 404.1520). “If the claimant fails at s tep three, the ALJ must determine the claimant’s residual functional capacity ( “ RFC ” ), which is the most the claimant can still do despite physical and mental limitations that affect her ability to
work .” Shinaberry v. Saul , 952 F.3d 113, 119 (4th Cir. 2020) (cleaned up). Then , a t step four, the ALJ applies the RFC to determine if “the claimant has proven that she is unable to perform past work.” Id. at 119. “If so, the ALJ proceeds to step five, where the burden shifts to the [Agency] to prove, by a prepon derance of the evidence, that the claimant can USCA4 Appeal: 22-1759 Doc: 26 Filed: 12/28/2023 Pg: 2 of 63 perform other work that exists in significant numbers in the national economy, considering the claimant’s RFC, age, education, and work experience.” Id. (cleaned up).
On remand , t he ALJ found at steps one and two that Cummings ha d not worked
since 2014 and had several severe impairments, including bilateral carpal tunnel syndrome
and mild arthritis of the elbows and knees , though not fibromyalgia. At step three, t he ALJ
determine d that none of Cummings ’s severe impairments me t or medically equal ed one of the impairments listed in 20 C.F.R. Part 404, Subpart P, Appendix 1

. The ALJ accordingly
conducted an RFC assessment and concluded that Cummings could “ perform light work as defined in 20 CFR 416.967(b),” with additional limitations on posture, manipulative movements, and environmental

- hazard exposure. Based on this RFC, the ALJ found at step four that Cummings could not perform her past work as a car detailer. But , at step
five , t he ALJ deter mined that tens of thousands of jobs were nonetheless available to Cummings in the national economy , and denied her claim

. The district court affirmed the Agency’s d ecision , and Cummings appealed.

II. We review the district court’s decision de novo and will affirm the Agency if “the ALJ has applied correct legal standards and the ALJ’s factual findings are supported by
substantial evidence.” Shinaberry , 952 F.3d at 120 (cleaned up) ; see 42 U.S.C. § 405(g). “Substantial evidence is that which a reasonable mind might accept as adequate to support
a conclusion.” Pearson v. Colvin , 810 F.3d 204, 207 (4th Cir. 2015) (cleaned up)

. We will

not “reweigh conflicting evidence, make credibility determinations, or substitute our USCA4 Appeal: 22-1759 Doc: 26 Filed: 12/28/2023 Pg: 3 of 64 judgment for that of the ALJ.” Shinaberry , 952 F.3d at 123 (cleaned up). We will also defer to the ALJ “where conflicting evidence allows reasonable minds to differ as to
whether a claimant is disabled.” Id. (cleaned up). Cummings raises several challenges on appeal to the Agency’s analysis , all of which
fail. She first challenges the ALJ’s determination that her fibromyalgia did not constitute a severe impairment. But, as the Agency points out, Cummings forfeited this argument by failing to raise it before the district court. See Hicks v. Ferr eyra , 965 F.3d 302, 310 (4th Cir. 2020)

. Cummings has also not identif ied any “exceptional circumstances” that would justify departing from our rule against “ consider [ing] issues raised for the first time

on appea l.” See i d

. (cleaned up)

. We therefore find that Cummings has forfeited her arguments regarding fibromyalgi a , and do not address them further

. Nor did the Agency err in its RFC assessment when it found that Cummings’s

statements about her symptoms ’ intensity and persistence w ere inconsistent with other
evidence in the record

. A claimant’s statements regarding her symptoms “need not be accepted to the extent they are inconsistent with the available evidence , including objective
evidence of the underlying impairment, and the extent to which that impairment can reasonably be expected to cause the pain the claimant alleges she suffered .” Craig v.
Chater , 76 F.3d 585, 595 (4th Cir. 1996 )

. Several medical examinations reported that Cummings, contrary to her reported symptom s , could walk normally without the assistance
of a cane or walker

. The ALJ also determined that Cummings’s impairments were “mild,” a finding based directly on the statements of medical experts in the record. T he ALJ further noted the conservative management of Cummings’s symptoms

— w ho report ed tak ing USCA4 Appeal: 22-1759 Doc: 26 Filed: 12/28/2023 Pg: 4 of 65 only ibuprofen for her pain and inconsistently using her prescribed wrist braces

— as well
as her daily activities, such as personal grooming and hygiene, supervising her children during homeschooling, and being the primary caregiver for her young grandchild. These are all relevant factors when evaluating a claimant’s symptoms and their potential limiting
effects. 40 C.F.R. § 416.929(c)(3)(i)

- (vii). * Finally, the Agency adequately explained why it gave little weight to a medical

source statement of Dr. Perkis, a treating physician of Cummings

. Dr. Perki s based that statement solely on Cummings’s reported symptoms rather than objective evidence ; the

statement conflicted with ot her medical evaluations before the Agency o n Cummings’s
condition ; and the statement did not explain the connection between the symptoms reported
and almost all of the work limitations identified

. The ALJ did not need to give co ntrolling weight to a medical statement unsupported by objective evidence and inconsistent with
substantial evidence in the record

. See Arakas v. Comm’r, Soc. Sec. Admin. , 983 F.3d 83, 106 (4th Cir. 2020) (citing 20 C.F.R. § 416.927(c)(2) )

. In short, Cummings asks us to reweigh conflicting evidence in the record. This we
will not do. Shinaberry , 952 F.3d at 123. We affirm the Agency’s thorough and reasoned decision as supported by substantial evidence. We dispense with oral argument because

* Cummings additionally argues that the ALJ disregarded evidence of frequent unplanned doctor visits that would lead to absenteeism incompatible with employment, but she cites no part of the record in support of this assertion. USCA4 Appeal: 22-1759 Doc: 26 Filed: 12/28/2023 Pg: 5 of 66 the facts and legal contentions are adequately presented in the materials before this court and argument would not aid the decisional process.
AFFIRMED USCA4 Appeal: 22-1759 Doc: 26 Filed: 12/28/2023 Pg: 6 of 6