UNPUBLISHED
UNITED STATES COURT OF APPEALS
FOR THE FOURTH CIRCUIT
No. 17-1366
LEON L. LADDA, JR.,
Plaintiff – Appellant,
v.
NANCY A. BERRYHILL,
Defendant – Appellee.
Appeal from the United States District Court for the Western District of North Carolina,
at Charlotte. Richard L. Voorhees, Senior District Judge. (3:15-cv-00257-RLV)
Argued: September 26, 2018 Decided: October 18, 2018
Before DUNCAN and DIAZ, Circuit Judges, and John A. GIBNEY, Jr., United States
District Judge for the Eastern District of Virginia, sitting by designation.
Affirmed by unpublished opinion. Judge Duncan wrote the opinion, in which Judge Diaz
and Judge Gibney joined.
ARGUED: Dana Wayne Duncan, DUNCAN DISABILITY LAW, S.C., Nekoosa,
Wisconsin, for Appellant. Christian Michael Vainieri, SOCIAL SECURITY
ADMINISTRATION, Baltimore, Maryland, for Appellee. ON BRIEF: Jill
Westmoreland Rose, United States Attorney, Charlotte, North Carolina, Gill P. Beck,
Assistant United States Attorney, OFFICE OF THE UNITED STATES ATTORNEY,
Asheville, North Carolina, for Appellee.
Unpublished opinions are not binding precedent in this circuit.
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DUNCAN, Circuit Judge:
Plaintiff-Appellant Leon Ladda, Jr. challenges the decision of a Social Security
Administration (“SSA”) Administrative Law Judge (an “ALJ”) finding him not disabled
and denying his application for disability insurance benefits and supplemental security
income. Ladda contends that the ALJ erred in finding Ladda’s subjective statements
about his symptoms not entirely credible and in determining Ladda’s residual functional
capacity to work (his “RFC”). We hold that the ALJ applied correct legal standards and
that his factual findings were supported by substantial evidence. Accordingly, we affirm
the district court and uphold the ALJ’s decision.
I.
In December 2011, Ladda applied for disability insurance benefits and
supplemental security income with the SSA. The SSA denied Ladda’s application, and
he filed a request for reconsideration, which the SSA also denied.
Ladda requested an administrative hearing and appeared before an SSA ALJ in
August 2013. The ALJ heard testimony from Ladda and from a vocational expert (a
“VE”), and he reviewed Ladda’s medical records and the opinions of his physicians.
Medical evidence that the ALJ considered included x-rays that showed that Ladda’s
injuries were healing, test results that showed that Ladda’s sensation and range of motion
were normal, and records that showed no significant changes to Ladda’s pain medications
and no reports of side effects from those medications. The ALJ considered Ladda’s
reports that he could perform some daily tasks, such as brushing his hair, shopping for
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groceries, and performing household chores. The ALJ also considered Ladda’s testimony
that he experiences regular pain, frequently uses a wheelchair or crutches, experiences
side effects from his pain medications, and cannot walk for more than ten to fifteen
minutes or lift more than ten pounds.
Following the hearing, the ALJ denied Ladda’s claims and found that Ladda was
not disabled. In his analysis, the ALJ found that Ladda’s subjective statements about his
symptoms were not entirely credible and that Ladda was capable of light work. The SSA
Appeals Council declined to review the decision. Ladda sought review of the ALJ’s
decision in the district court, which granted summary judgment for the SSA and affirmed
the ALJ’s decision in February 2017. This appeal followed.
II.
Ladda challenges (1) the ALJ’s determination that Ladda’s testimony regarding
his pain and abilities was not entirely credible and (2) the ALJ’s procedures and
reasoning in his assessment of Ladda’s RFC. This court “review[s] a district court’s
grant of a motion for summary judgment de novo, applying the same legal standards as
the district court.” Nader v. Blair, 549 F.3d 953, 958 (4th Cir. 2008). Accordingly,
“[w]hen examining an SSA disability determination, a reviewing court is required to
uphold the determination when an ALJ has applied correct legal standards and the ALJ’s
factual findings are supported by substantial evidence.” Bird v. Comm’r of Soc. Sec.
Admin., 699 F.3d 337, 340 (4th Cir. 2012). When reviewing for substantial evidence,
“we do not undertake to reweigh conflicting evidence, make credibility determinations,
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or substitute our judgment for that of the [ALJ].” Hancock v. Astrue, 667 F.3d 470, 472
(4th Cir. 2012) (alteration in original) (citation omitted).
In this case, the ALJ’s credibility determination and RFC assessment apply correct
legal standards and are supported by substantial evidence. Accordingly, we affirm the
district court’s grant of summary judgment for the SSA and the ALJ’s decision to deny
Ladda’s application for disability insurance benefits and supplemental security income.
We briefly describe the statutory and regulatory framework that the ALJ applied before
explaining our decision to uphold the ALJ’s credibility determination and RFC
assessment.
A.
The Social Security Act entitles eligible disabled individuals to disability
insurance benefits and supplemental security income. 42 U.S.C. §§ 423, 1382. ALJs
follow a five-step procedure when determining whether a claimant is disabled.
20 C.F.R. §§ 404.1520, 416.920. If the ALJ determines at any step that a claimant is or is
not disabled, the inquiry ends. Step 1 asks whether the claimant is working. Id. If not,
step 2 asks whether he has a “severe medically determinable physical or mental
impairment.” Id. Step 3 asks whether the claimant’s impairment “meets or equals” a
listed impairment that would automatically define him as disabled. Id. If the ALJ does
not find the claimant disabled at step 3, he must determine the claimant’s RFC--his
remaining capacity to do sustained work activities despite his physical or mental
impairments. See id. §§ 404.1520(e), 404.1545, 416.920(e), 416.945. As part of this
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determination, the ALJ must assess the credibility of any subjective statements by the
claimant about his symptoms. Id. §§ 404.1529(c)(4), 416.929(c)(4); Soc. Sec. Ruling
(“SSR”) 96-8p, 1996 WL 374184 at *7 (Jul. 2, 1996).
After the RFC assessment, the ALJ proceeds to step 4 and determines whether the
claimant can still do his “past relevant work” in light of his impairments and the RFC
assessment. 20 C.F.R. §§ 404.1520, 416.920. If the claimant cannot perform past
relevant work, the burden of proof shifts from the claimant to the SSA at step 5. See
42 U.S.C. § 423(5)(A); 20 C.F.R. §§ 404.1512(a)–(b), 416.912(a)–(b), 404.1520(g),
416.920(g). There, the SSA must “demonstrate that the impairment does not prevent the
claimant from engaging in other substantial gainful employment.” Patterson v. Comm’r
of Soc. Sec. Admin., 846 F.3d 656, 660 (4th Cir. 2017); see 20 C.F.R. §§ 404.1520,
416.920. At this stage, the ALJ considers the RFC assessment and the claimant’s age,
education, and work experience. 20 C.F.R. §§ 404.1520, 416.920. The ALJ will often
rely on the testimony of a VE at this step to establish whether a hypothetical person with
the claimant’s limitations and abilities could readily find employment that “exists in
significant numbers in the national economy.” Mascio v. Colvin, 780 F.3d 632, 635 (4th
Cir. 2015) (internal quotation marks and citations omitted).
In this case, at steps 1 and 2, the ALJ found that Ladda was not working and had
severe impairments. At step 3, he found that Ladda’s impairments did not meet or equal
any listed impairment. The ALJ performed an RFC assessment and found that Ladda had
the residual functional capacity to perform “light work” except that Ladda was “limited
to [only] occasional climbing and balancing.” A.R. 22. Critically, at this stage, the ALJ
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found that Ladda’s statements about his pain and limitations were only partially credible.
At step 4, the ALJ found that Ladda was not able to perform any past relevant work
because the demands of his past work as a baker “exceed[ed] his residual functional
capacity.” A.R. 27. At step 5, however, the ALJ concluded that Ladda was not disabled
because VE testimony established that someone with Ladda’s RFC, age, 1 education, and
work experience could perform certain available occupations. On appeal, Ladda
challenges both the ALJ’s determination that Ladda’s testimony regarding his pain and
abilities was not entirely credible and the ALJ’s procedures and reasoning in his RFC
assessment.
B.
We first determine whether the ALJ’s credibility determination applied correct
legal standards and was supported by substantial evidence. An ALJ assesses the
credibility of a claimant’s subjective statements about his condition as part of the RFC
assessment. When conducting the RFC assessment, the ALJ must consider all relevant
evidence in the record, including medical records, reports of daily activities, and “effects
1
Regarding Ladda’s age, the ALJ stated that Ladda was “51 years old, which is
defined as a younger individual age 18–49, on the alleged disability onset date.” A.R. 27.
However, under the regulations, Ladda, who falls between the ages of 50–54, is a
“[p]erson closely approaching advanced age.” See 20 C.F.R. § 404.1563(d). ALJs are
required to consider a claimant’s age in step 5 of the disability determination if the
claimant falls into that category. Id. § 404.1563(c)–(d). Here, the ALJ did consider
Ladda’s age in step 5, see A.R. 28, so any mistake he committed with respect to his
statement about Ladda’s age category did not affect his disability determination.
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of symptoms, including pain, that are reasonably attributed to a medically determinable
impairment.” SSR 96-8p at *7. When a claimant makes statements about his symptoms,
the ALJ must determine the credibility of those statements and explain his assessment.
20 C.F.R. §§ 404.1529(c)(4), 416.929(c)(4); see SSR 96-7p, 1996 WL 374186 (Jul. 2,
1996). 2 Ladda argues that the ALJ did not have substantial evidence to support his
finding that Ladda’s statements about his pain and other symptoms were not entirely
credible. However, we uphold the ALJ’s credibility determination because the ALJ
explained his reasoning and weighed Ladda’s subjective statements against other
evidence.
SSA regulations set out a two-step process that ALJs must follow when evaluating
a claimant’s subjective statements about his impairments and symptoms.
20 C.F.R. §§ 404.1529, 416.929. First, the ALJ considers the objective medical evidence
to determine whether the claimant’s medical impairments “could reasonably be expected
to produce the pain or other symptoms alleged.” Id. Second, the ALJ evaluates the
“intensity and persistence of [the claimant’s] symptoms” and “determin[es] the extent to
which [those] symptoms limit [the claimant’s] capacity for work.” Id. At the second
step, the ALJ must “assess the credibility of the claimant’s statements about symptoms
and their functional effects.” Lewis v. Berryhill, 858 F.3d 858, 866 (4th Cir. 2017) (citing
2
SSR 16-3p superseded SSR 96-7p on March 16, 2016. SSR 16-3p, 2016 WL
1119029 at *1 (Mar. 16, 2016). However, SSR 96-7p was in effect on November 21,
2013 when the ALJ made his determination here, and neither party contends that it does
not apply.
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20 C.F.R. §§ 404.1529(c)(4), 416.929(c)(4)). Here, the ALJ found that Ladda’s
“medically determinable impairments could reasonably be expected to cause the alleged
symptoms” of pain and limited mobility at the first step of this analysis. A.R. 23.
However, at the second step, the ALJ explained that Ladda’s statements regarding the
extent to which the symptoms affected his ability to work were not fully credible when
compared with other evidence on the record.
When an ALJ makes a credibility determination, he must “consider the entire case
record, including the objective medical evidence, the individual’s own statements about
symptoms, [and] statements . . . by treating or examining physicians.” SSR 96-7p at *1.
In this analysis, the ALJ must “build an accurate and logical bridge from the evidence to
his conclusion that the claimant’s testimony was not credible.” Brown v. Comm’r Soc.
Sec. Admin., 873 F.3d 251, 269 (4th Cir. 2017) (internal quotations and alterations
omitted).
Here, after considering Ladda’s subjective statements, the ALJ concluded that
Ladda’s pain could be managed through medication and did not limit his ability to
perform light work. The ALJ supported this conclusion through discussion and analysis
of the evidence. The ALJ discussed Ladda’s relevant medical records, such as x-rays that
showed that he was healing and test results that demonstrated normal sensation and range
of motion. The ALJ also discussed Ladda’s statements about his pain, physical
limitations, and daily abilities. The ALJ gave a number of reasons, supported by
substantial evidence, for finding that these statements were “not entirely credible.” A.R.
23. For instance, he explained that, though Ladda complained of pain, the medical record
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did not show “any significant changes . . . to [Ladda’s] medications or dosages,” which
suggested to the ALJ that Ladda’s existing treatments sufficiently managed his pain.
A.R. 25. The ALJ also noted that Ladda failed to follow his doctor’s advice and pursue
physical therapy at home when such activities could have helped ease his pain. A.R. 26.
The ALJ sufficiently explained how he used the evidence to reach his conclusion that
Ladda’s statements about his symptoms were not entirely credible. 3
When determining credibility, the ALJ must also consider whether a claimant’s
statements about pain and other symptoms conflict with other evidence on the record,
including objective medical evidence and statements by physicians about how the
claimant’s symptoms affect him. See 20 C.F.R. §§ 404.1529(c)(4), 416.929(c)(4) (stating
the standard for evaluating subjective symptoms); Brown, 873 F.3d at 269 (explaining
that this standard applies during the credibility determination). The ALJ cannot “reject [a
claimant’s] statements about the intensity and persistence of . . . pain or other symptoms”
or about the effect of those symptoms on a claimant’s ability to work “solely because the
available objective medical evidence does not substantiate [them].”
20 C.F.R. §§ 404.1529(c)(2), 416.929(c)(2).
3
Ladda also contends that the ALJ failed to mention facts in the record that
supported Ladda’s statements. An ALJ “cannot simply cherrypick facts that support a
finding of nondisability while ignoring evidence that points to a disability finding.”
Lewis, 858 F.3d at 869 (citation omitted). However, when we review an ALJ’s
credibility determination, we do not “substitute our judgment for that of the [ALJ],”
Hancock, 667 F.3d at 472, and here, the ALJ cited adequate evidence from the record to
support his conclusion that Ladda’s statements were not entirely credible.
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In this case, the ALJ acknowledged Ladda’s pain but explained that no medical
evidence demonstrated that his pain was a “continuing impairment of incapacitating
proportions.” A.R. 25. An ALJ cannot base his credibility determination solely on
objective medical evidence, but that was not the end of the ALJ’s analysis here. See 20
C.F.R. §§ 404.1529(c)(2), 416.929(c)(2). Instead, the ALJ noted that Ladda made
conflicting statements at the hearing and to his physicians about whether his pain
medication caused side effects, and he considered Ladda’s medication and treatment
history, which also cut against Ladda’s statements about his pain. We are not
unsympathetic to the difficulty of articulating a subjective symptom like pain, but the
ALJ did not reject Ladda’s statements out of hand. Instead, he compared them with the
other evidence on the record, including objective medical evidence and Ladda’s
conflicting statements. The weight he assigned to Ladda’s statements after comparing
them with other evidence is therefore supported by substantial evidence.
Admittedly, our inquiry would be more straightforward if the ALJ had not made
comments that were unnecessary to the disability determination, such as his statement
that “despite the advice of his physicians, [Ladda] continues to smoke, which may well
be a factor in aggravation of his medical problems.” A.R. 26; see Lewis, 858 F.3d at 869
(chastising an ALJ for “playing doctor” when the ALJ’s statement is not supported by
any medical evidence). However, on appeal, we look to whether the ALJ’s decision was
supported by substantial evidence, and in doing so, “we do not undertake to reweigh . . .
[the] evidence.” Hancock, 667 F.3d at 472. Under this standard, the ALJ’s
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determination here was more than adequately in accord with the regulations and our
precedent, despite his extraneous remarks.
Therefore, we uphold the ALJ’s determination that Ladda’s subjective statements
were only partially credible.
C.
We next determine whether the ALJ’s RFC assessment applied correct legal
standards and was supported by substantial evidence. Ladda alleges that the ALJ
(1) failed to include a narrative discussion of the evidence in the RFC assessment and
(2) failed to perform the RFC assessment on a function-by-function basis. We uphold the
RFC assessment because the ALJ explained his reasoning and assessed Ladda’s
functional abilities and limitations in accordance with our standard in Mascio, 780 F.3d
632.
In the RFC assessment, the ALJ uses all relevant evidence, medical or otherwise,
to determine a claimant’s “ability to meet the physical, mental, sensory, and other
requirements of work.” 20 C.F.R. §§ 404.1545, 416.945. A claimant’s RFC represents
“the most [he] can still do despite [his] limitations.” Id. SSA guidance directs the ALJ to
first consider a claimant’s abilities on a “function-by-function basis” before expressing a
claimant’s RFC in terms of exertional levels: “sedentary, light, medium, heavy, [or] very
heavy.” SSR 96-8p at *1; see Mascio, 780 F.3d at 636–37 (explaining that an ALJ must
explain how he evaluated a claimant’s residual functional capacity). Here, the ALJ
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determined that Ladda was capable of light work, except that he was “limited to
occasional climbing and balancing.” A.R. 22.
An RFC assessment “must include a narrative discussion describing how the
evidence supports each conclusion, citing specific medical facts . . . and nonmedical
evidence.” SSR 96-8p at *7. The ALJ must identify the evidence relied upon and “build
an accurate and logical bridge from the evidence to [the] conclusion.” Monroe v. Colvin,
826 F.3d 176, 189 (4th Cir. 2016) (holding that an ALJ’s failure to do so was reversible
error).
Here, the ALJ sufficiently explained his conclusions when conducting the RFC
assessment. In Monroe, an ALJ’s RFC assessment was not supported by substantial
evidence when he failed to explain his decision to rely on certain medical records while
ignoring others and when he failed to include a narrative discussion describing how he
decided to weigh the evidence. Id. at 189–90. In contrast, the ALJ in this case used
evidence from the record to explain his finding that Ladda was capable of light work.
For example, the ALJ noted that Ladda claimed that he could walk for only ten to fifteen
minutes at a time and could not lift ten pounds, but he explained that the other evidence
in the record, such as medical records and opinion evidence, did not fully substantiate
these claims. The ALJ also explained the relative weight he assigned to the statements
made by Ladda, Ladda’s treating physician, and the state agency medical consultants.
The ALJ provided a sufficiently thorough discussion for us to agree that his conclusion
that Ladda was limited to light work was supported by substantial evidence.
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SSA guidelines instruct the ALJ to take a “function-by-function” approach to
determining a claimant’s RFC. SSR 96-8p at *1. The function-by-function approach
asks the ALJ to consider a claimant’s specific “exertional and nonexertional functions”
when determining the claimant’s RFC. Id. at *5. In Mascio, we “rejected a per se rule
requiring remand when the ALJ does not perform an explicit function-by-function
analysis.” Mascio, 780 F.3d at 636 (citing Cichocki v. Astrue, 729 F.3d 172, 177 (2d.
Cir. 2013) (per curiam)). Instead, we stated that “remand may be appropriate where an
ALJ fails to assess a claimant’s capacity to perform relevant functions, despite
contradictory evidence in the record, or where other inadequacies in the ALJ’s analysis
frustrate meaningful review.” Id. (quotations, alterations, and citation omitted). For
example, in Mascio, remand was appropriate where an ALJ’s RFC assessment was not
supported by substantial evidence because he failed to address conflicting evidence in the
record and to include an analysis of whether the claimant could perform certain functions
for an entire workday. Id. at 637.
Here, the ALJ satisfied the requirements of Mascio when he assessed Ladda’s
RFC. He discussed Ladda’s ability to sit, stand, and walk, and he explained that Ladda’s
physicians opined that Ladda did not need to rely on a cane or crutches. Ladda argues
that the ALJ did not perform a function-by-function analysis because the ALJ did not
discuss Ladda’s reduced grip strength and limited use of his left leg and right hand.
However, the ALJ did assess Ladda’s capacity to stand, walk, and lift, which are all
functions that are related to those physical limitations.
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Further, we need not remand because the record in this case is adequate. Unlike
the ALJ in Mascio, the ALJ here addressed conflicting evidence in the record and
explained that Ladda’s pain would not prevent him from working for an entire workday. 4
See id. Accordingly, we uphold the ALJ’s RFC assessment as supported by substantial
evidence rather than remand.
III.
We affirm the district court and uphold the ALJ’s disability determination because
the ALJ applied correct legal standards and his conclusions were supported by substantial
evidence.
AFFIRMED
4
Ladda claims that the ALJ erred in assessing Ladda’s daily activities as evidence
of Ladda’s ability to work for an entire day. However, the ALJ cited Ladda’s daily
activities for purposes of the credibility determination and not as examples of the
functions Ladda could perform for an entire day.
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