UNPUBLISHED

UNITED STATES COURT OF APPEALS

FOR THE FOURTH CIRCUIT

No. 22-1759

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 Judges, and MOTZ, Senior Circuit 

Judge. 

Affirmed by unpublished per curiam opinion.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Unpublished opinions are not binding precedent in this circuit.

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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 2017, but the district court vacated 

the decision and remanded for further consideration of Cummings’s hand impairments. 

Another ALJ held a new hearing on remand and also found that Cummings was not 

disabled. This time, the district court upheld the decision. For the reasons that follow, we 

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, 

659 (4th Cir. 2017) (quoting 20 C.F.R. § 404.1520). “If the claimant fails at step 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, at 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 preponderance of the evidence, that the claimant can 

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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, the ALJ found at steps one and two that Cummings had 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, the ALJ 

determined that none of Cummings’s severe impairments met or medically equaled 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, the ALJ determined 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 decision, 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 

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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. Ferreyra, 965 F.3d 302, 310

(4th Cir. 2020). Cummings has also not identified any “exceptional circumstances” that 

would justify departing from our rule against “consider[ing] issues raised for the first time 

on appeal.” See id. (cleaned up). We therefore find that Cummings has forfeited her

arguments regarding fibromyalgia, 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 were 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 symptoms, 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. The ALJ further

noted the conservative management of Cummings’s symptoms — who reported taking

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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. Perkis based that 

statement solely on Cummings’s reported symptoms rather than objective evidence; the 

statement conflicted with other medical evaluations before the Agency on 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 controlling 

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.

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the facts and legal contentions are adequately presented in the materials before this court 

and argument would not aid the decisional process.

AFFIRMED

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