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Harms V Bisignano

                UNITED STATES DISTRICT COURT                             
                    DISTRICT OF MINNESOTA                                


Timothy H.,                             No. 24-cv-2627 (DLM)             

               Plaintiff,                                                


v.                                                                       
                                              ORDER                      

Frank Bisignano,                                                         
Commissioner of Social Security,                                         

               Defendant.                                                


    Plaintiff Timothy H. seeks judicial review of the final decision of the Commissioner 
of Social Security (“Commissioner”) denying his applications for Disability Insurance 
Benefits (“DIB”) and Supplemental Security Income (“SSI”). See 42 U.S.C. § 405(g). This 
matter is before the Court on the parties’ briefs seeking judgment on the administrative 
record. (Docs. 5 (Plaintiff’s motion for summary judgment), 6 (Plaintiff’s memorandum), 
8 (Commissioner’s brief).) Both parties have voluntarily consented to the undersigned 
magistrate judge’s review of this matter. For the reasons below, the Court affirms judgment 
in favor of the Commissioner.                                             
                         BACKGROUND                                      
    In August 2020, Plaintiff applied for SSI, and in January 2021, he filed for DIB, 
alleging in both applications that he had been disabled since May 2020. (Tr.1 at 328–31, 

335–36, 352–63). The Social Security Administration (“SSA”) denied his claims initially 
and upon reconsideration. (Tr. at 75–184.) Plaintiff then requested a hearing before an 
Administrative Law Judge (“ALJ”), and the ALJ held a hearing by telephone on the matter 
on November 18, 2021. (Tr. at 232–33 (request for hearing), 32–74 (hearing transcript).) 
Based on the record and hearing, the Commissioner issued an unfavorable decision on 

January 13, 2022. (Tr. at 8–28.) The SSA Appeals Council denied Plaintiff’s request for 
review. (Tr. at 1–4.) Plaintiff then filed a federal action seeking judicial review, and the 
court remanded the matter to the SSA upon a voluntary motion for remand by the agency 
because the record contained an erroneous exhibit that belonged to a different plaintiff. See 
Timothy H. v. Kijakazi, 23-cv-351 (DTS) (Docs. 11 (Motion for Remand), 13 (Order for 

Remand)). Following this, the SSA vacated its decision and ordered the ALJ to update the 
evidence on Plaintiff’s impairments and further consider his residual functional capacity 
(“RFC”)2 with supplemental evidence from a vocational expert, if necessary. (Tr. at 1299–
1300.)                                                                    


1 The Commissioner filed the consecutively paginated transcript of the administrative 
record on September 3, 2024. (Docs. 4 through 4-3.) For ease of reference, citations to the 
transcript will identify the page number listed on the lower right corner of the document 
rather  than  the  exhibit  number  and  will  treat  the  four  parts  as  a  single,  continuous 
document.                                                                 
2 A plaintiff’s RFC is the measure of the “the most [they] can still do despite [their] 
limitations.” 20 C.F.R. §§ 404.1545(a)(1), 416.945(a)(1).                 
    As ordered, a new ALJ received additional treatment notes into the record and 
removed the mistakenly included irrelevant portion. (Tr. at 1247, 1465–1537.) The new 
ALJ also held a new administrative hearing on March  19, 2024, eliciting additional 

testimony from a vocational expert based on the updated record. (Tr. at 1243–65.) Counsel 
represented Plaintiff at that hearing, and Plaintiff testified on his own behalf. (Tr. at 1243–
45, 1249–57.) A vocational expert also testified, concluding that if Plaintiff were limited 
to light work with some postural and environmental limitations, he could still perform jobs 
in the national economy as a housekeeper (Dictionary of Occupational Titles (“DOT”) No. 

323.687-014), mailroom clerk (DOT No. 209.687-026), and merchandise marker (DOT 
No. 209.587-034). (Tr. at 1259.) Plaintiff’s counsel also questioned the vocational expert 
during the hearing about the postural and fingering requirements for these identified roles. 
(Tr. at 1262–64.)                                                         
    On May 1, 2024, the Commissioner again sent his notice of an unfavorable decision 

to  Plaintiff.  (Tr.  at  1214–16  (notice),  1217–35  (decision).)  The  ALJ  recognized  that 
Plaintiff suffered from several severe impairments, including “lumbar degenerative disc 
disease with grade 1 L5-S1 spondylolisthesis, other unspecified arthropathies; depressive, 
bipolar,  and  related  disorders;  anxiety,  personality  and  impulsive  control  disorders; 
posttraumatic stress disorder (PTSD); and alcohol use disorder (AUD).” (Tr. at 1220.) The 

ALJ also found a number of non-severe or not medically determinable impairments that 
have limited Plaintiff’s functional abilities for at least a 12-month basis, including a 
cannabis use disorder, shortness of breath, right hand cramping, and dislocation of the 
knees. (Tr. at 1221.) Despite Plaintiff’s mental and physical impairments, the ALJ found 
that she did not qualify for benefits. (Tr. at 1234–35.)                  
    First, the ALJ determined that Plaintiff retained the RFC to perform light work as 

defined by 20 C.F.R. §§ 404.1567(b) and 416.967(b), provided the job included additional 
postural and environmental limitations. The ALJ found that Plaintiff must only work in 
roles where he can avoid concentrated exposure to vibrations, extremely cold temperatures, 
hazards like working in uneven terrain or around unprotected heights, and the operation of 
heavy machinery or driving. (Tr. at 1225.) The ALJ likewise determined Plaintiff can only 

work in roles that require him to occasionally lift and carry 20 pounds, climb, stoop, or 
maintain superficial interactions with others like taking instructions, relaying information, 
or transferring materials. (Id.) The ALJ opined that Plaintiff can perform work that requires 
him to frequently carry 10 pounds, although he can only push or pull weight of no more 
than he can lift and carry. (Id.) Finally, the ALJ concluded that Plaintiff can sustain work 

requiring him to sit for up to six hours and stand or walk for up to six hours in an eight-
hour workday, as well as to concentrate, understand, and remember routine, repetitive, or 
three to four step instructions, which the ALJ found should adequately accommodate his 
capacity to tolerate workplace stressors. (Id.)                           
    Next, the ALJ credited the testimony of the vocational expert that although Plaintiff 

could not perform his past relevant work, he could still perform other work in the national 
economy as a  housekeeper,  mailroom clerk, and merchandise marker.  (Tr. at 1234.) 
Because Plaintiff could still adjust to perform other work despite his limitations, the ALJ 
found him not disabled under the evaluative process set forth in 20 C.F.R. §§ 404.1520(g) 
and 416.920(g). (Tr. at 1234–35.) Plaintiff chose not to file an appeal, making the ALJ’s 
decision the final decision of the Commissioner. (Tr. at 1214–15 (describing the SSA 
appeals process, including an applicant’s right to file a civil action in federal court).) 

    Plaintiff then filed this federal action seeking judicial review of the Commissioner’s 
decision. (Doc. 1.) He challenges the ALJ’s determination that he is not disabled, arguing 
that substantial evidence in the record as a whole does not support the ALJ’s RFC 
determination about his mental impairment-related limitations. Plaintiff argues that to 
reach  his  conclusions,  the  ALJ  cherry-picked  record  evidence  on  Plaintiff’s  mental 

impairments to inaccurately conclude that they cause at-most moderate limitations when 
they are far more severe. The ALJ then compounded his error, according to Plaintiff, by 
using these unsupported conclusions to pose hypothetical questions to the vocational expert 
that failed to capture the true impact of Plaintiff’s mental impairments. Consequently, the 
vocational expert’s testimony, Plaintiff claims, is unsupported by the record and cannot 

provide a sound evidentiary basis for the ALJ’s conclusions. Plaintiff argues that this error 
is particularly egregious because the ALJ flouted the SSA Appeals Council’s express 
directive on remand that the ALJ ensure any hypothetical questions posed to a vocational 
expert reflect the record evidence as a whole. Based on this series of errors, Plaintiff asks 
the Court to reverse the ALJ’s decision and remand the matter for reevaluation by the SSA. 

                           ANALYSIS                                      
    This Court reviews an ALJ’s denial-of-benefits decision to determine whether it is 
supported by substantial evidence in the record as a whole, and whether the decision is 
infected by legal error. 42 U.S.C. § 405(g); Austin v. Kijakazi, 52 F.4th 723, 728 (8th Cir. 
2022). Substantial evidence means “such relevant evidence as a reasonable mind might 
accept as adequate to support a conclusion.” Biestek v. Berryhill, 139 S. Ct. 1148, 1154 
(2019) (internal quotations omitted); see also Nash v. Comm’r, Soc. Sec. Admin, 907 F.3d 

1086,  1089  (8th  Cir.  2018)  (characterizing  “substantial  evidence”  as  “less  than  a 
preponderance, but enough that a reasonable mind would find it adequate to support the 
Commissioner’s conclusions”). Courts reviewing ALJ decisions must look to the entire 
administrative record to ascertain whether it contains sufficient evidence to support the 
ALJ’s conclusion. Grindley v. Kijakazi, 9 F.4th 622, 627 (8th Cir. 2021). When substantial 

evidence supports the ALJ’s decision, the Court will not reverse, even if substantial 
evidence also supports a contrary outcome. Nash, 907 F.3d at 1089. But if an ALJ used 
erroneous legal standards, or if they incorrectly applied the law, those may be reversible 
legal errors. Joel M. B. v. Kijakazi, No. 21-cv-1660 (PAM/ECW), 2022 WL 1785224, at 
*2 (D. Minn. June 1, 2022) (citing Collins v. Astrue, 648 F.3d 869, 871 (8th Cir. 2011)); 

Michael B. v. Kijakazi, No. 21-cv-1043 (NEB/LIB), 2022 WL 4463901, at *1 (D. Minn. 
Sept. 26, 2022).                                                          
    Plaintiff does not contest that the ALJ followed the five-step sequential process laid 
out in 20 C.F.R. §§ 404.1520(a)(4) and 416.920(a)(4) for evaluating DIB and SSI claims, 
respectively.3 Rather, Plaintiff asserts that, in assessing his mental impairments and their 


3 Step one of this process involves determining whether a claimant is engaged in substantial 
gainful activity. 20 C.F.R. §§ 404.1520(a)(4)(i), 416.920(a)(4)(i). If not, the ALJ must next 
decide (in step two) whether the claimant’s impairments are severe, and of a duration of 
least 12 continuous months. Id. §§ 404.1520(a)(4)(ii), 416.920(a)(4)(ii). At step three, an 
ALJ determines whether the claimant’s impairments are severe enough to equal a listed 
impact on his ability to perform work, the ALJ departed from the record evidence to 
conclude Plaintiff’s mental impairments are less limiting than the full record suggests. As 
a result, the vocational expert’s testimony based on that evidence was flawed. This, 

Plaintiff claims, resulted in a denial of benefits that is not substantially supported by the 
record, and the Court will now turn to that record to review Plaintiff’s challenge. 
I.   THE ALJ’S STEP FIVE FINDING IS SUPPORTED BY SUBSTANTIAL              
    EVIDENCE.                                                            

    At step five of the sequential process, the SSA considers whether a disability 
claimant can perform work, given their age, education, work experience, and RFC. 20 
C.F.R. §§ 404.1520(a)(4)(v); 416.920(a)(4)(v). Here, it is undisputed that Plaintiff cannot 
perform his past relevant work, so it is the Commissioner’s burden to show that there are 
jobs available to him in the national economy, given his personal characteristics and 
limitations. Goff v. Barnhart, 421 F.3d 785, 790 (8th Cir. 2005). This Court reviews the 
ALJ’s determination under the substantial evidence standard. Ross v. O’Malley, 92 F.4th 
775, 778 (8th Cir. 2024).                                                 
    Plaintiff argues that the hypothetical questions that the ALJ posed to the vocational 

expert at Plaintiff’s second hearing did not reflect complete and accurate record evidence 


impairment  under  Appendix  1  to  Subpart  P  of  Part  404.  Id.  §§ 404.1520(a)(4)(iii), 
416.920(a)(4)(iii). If so, the claimant is considered disabled without further inquiry. If not, 
the ALJ must determine the claimant’s residual functional capacity (“RFC”) and decide (at 
step  four)  whether  the  claimant  can  still  do  their  past  work  given  their  limitations. 
Id. §§ 404.1520(a)(4)(iv),  416.920(a)(4)(iv).  Finally,  if  the  ALJ  concludes  a  claimant 
cannot perform their prior work, step five requires the ALJ to determine whether they can 
do  other  work  considering  their  RFC,  age,  education,  and  work  experience.  Id. 
§§ 404.1520(a)(4)(v), 416.920(a)(4)(v).                                   
on Plaintiff’s mental impairments. Plaintiff specifically claims that the ALJ misrepresented 
Plaintiff’s  difficulty  with  understanding,  remembering,  or  applying  information; 
interacting with others; concentrating, persisting, or maintaining pace; and adapting or 

managing himself. Plaintiff contends that this failure demonstrates the ALJ’s explicit 
disregard of the SSA Appeals Council’s directive on remand that the ALJ ensure his 
“hypothetical questions . . . reflect the specific capacity/limitations established by the 
record as a whole.” (Tr. at 1300.) The Court will first consider Plaintiff’s claim that the 
ALJ cherry-picked evidence on the functional impact of Plaintiff’s mental impairments. 

A.   Substantial evidence in the record as a whole supports the ALJ’s conclusion 
    that Plaintiff has at-most moderate functional limitations stemming from his 
    mental impairments.                                                  

    In evaluating the limitations a claimant’s mental impairments impose, an ALJ is 
directed to consider four broad functional areas called “paragraph B” criteria: (1) the 
claimant’s ability to understand, remember, or apply information; (2) the claimant’s ability 
to interact with others; (3) the claimant’s ability to concentrate, persist, or maintain pace; 
and (4) the claimant’s ability to adapt or manage oneself. 20 C.F.R. §§ 404.1520a(c)(3), 
416.920a(c)(3). An ALJ must rate the degree of a claimant’s impairment in each functional 
area based on a five-point scale: none, mild, moderate, marked, and extreme. 20 C.F.R. 
§§ 404.1520a(c)(3),  416.920a(c)(4);  see  also  SSA  POMS  DI  34001.032(F)(2), 
https://perma.cc/AA3X-XWFJ (last visited July 15, 2025) (describing the distinctions 
between each point on the severity scale in the Social Security Administration Program 
Operations Manual System (“POMS”)). Here, the ALJ evaluated the record evidence on 
Plaintiff’s mental impairments to assess the paragraph B criteria, determining that Plaintiff 
had moderate or mild limitations in each functional area. The Court will take each of the 
four areas in turn below.                                                 
    First, as to Plaintiff’s ability to understand, remember, or apply information, the 

ALJ determined that Plaintiff had moderate limitations. (Tr. at 1223.) The ALJ found that 
while Plaintiff testified that he lacked the cognitive ability to perform past roles that 
required reading and use of his memory, Plaintiff also submitted two function reports 
stating that he had no difficulty understanding and following directions. (Id.) Similarly, the 
ALJ noted that although Plaintiff claimed that he needed reminders to go places and 

significantly relied on his parents, he did not require reminders for medication or personal 
care and could live alone. (Id.) The ALJ likewise found that while at least one mental status 
examination showed that Plaintiff struggled with poor insight and judgment, Plaintiff also 
tested  in  the  average  range  for  intelligence—including  in  verbal  comprehension  and 
working memory—and showed an above average ability to reason. (Id.) The ALJ also 

pointed out that Plaintiff appeared able to follow the content of his hearing without 
difficulty. (Id.) On this mixed record, the  ALJ concluded the evidence  amount to  a 
moderate limitation in this functional area.                              
    Next, as to Plaintiff’s ability to interact with others, the ALJ found that Plaintiff also 
had a moderate limitation related to working with supervisors, coworkers, and the public. 

(Id.) The ALJ observed that Plaintiff testified he struggles with isolation, relies on his 
parents, lacks patience for social interactions, and finds interacting with authority figures 
challenging, which Plaintiff similarly endorsed in his function reports. (Id.) The ALJ noted 
that  Plaintiff’s  mental  health  records  show  he  struggles  with  feelings  of  anger  and 
irritability, and that he has anxiety and panic when in public settings or when required to 
interact with others. (Id.) Despite these mood-related concerns, the ALJ found the record 
on Plaintiff’s activities generally demonstrated that Plaintiff could interact with others, 

including spending time with his parents and shopping in stores. (Tr. at 1223–24.) Thus, 
here again, on the mixed record before him, the ALJ concluded a moderate limitation 
appeared indicated.                                                       
    As to Plaintiff’s ability to concentrate, persist, or maintain pace, the ALJ concluded 
he had only a mild limitation. (Tr. at 1224.)  The ALJ noted that Plaintiff’s hearing 

testimony did not include concerns about focusing on work activities or staying on task at 
a sustained pace, although Plaintiff’s function reports and treatment records include reports 
of  difficulty  with  these  functional  abilities.  (Id.)  Yet  when  medical  professionals 
administered standardized tests for deficits in these areas, the ALJ found it significant that 
Plaintiff tested within the normal range and had generally unremarkable mental status 

exams with generally normal attention and concentration. (Id.) The overall record, the ALJ 
concluded, suggested only a mild limitation in this area.                 
    Finally, as to Plaintiff’s ability to adapt or manage oneself, the ALJ determined that 
Plaintiff had moderate limitations in this area. (Id.) He acknowledged that Plaintiff claimed 
he has trouble with stress and changes to his routine in a work setting, but observed that 

Plaintiff’s stress management appeared most acute in relation to non-work-related areas, 
including his disability application process, finances, and emotional regulation. (Id.) The 
ALJ also remarked on Plaintiff’s struggles with suicidality and alcohol use, both of which 
he found show some limitations in Plaintiff’s self-management. (Id.) But the ALJ also 
determined that the record showed Plaintiff has attended psychotherapy but has been 
unwilling to take the prescribed psychotropic medications necessary to treat his conditions 
because  of past negative medication-related experiences. (Id.) And the ALJ found it 

particularly significant that, even without medication, Plaintiff’s mental health has not 
decompensated, and none of his medical providers have recommended more intensive 
treatment interventions like psychiatric hospitalization or residential treatment programs. 
(Id.) On balance, the ALJ concluded that, considering Plaintiff’s ability to live alone and 
perform various self- and home-care functions independently or with some support from 

his nearby parents, Plaintiff’s ability to adjust or manage himself does not merit greater 
than a moderate restriction. (Id.)                                        
Hearing Testimony                                                         
    The ALJ relied on both subjective and objective record evidence to reach these 
conclusions above, and Plaintiff claims that the ALJ cherry-picked evidence that is not 

what a reasonable mind would find representative of substantial record evidence. Drilling 
down to test the record related to this challenge, as to subjective evidence, the ALJ pointed 
to Plaintiff’s testimony about his mental impairment-related limitations during the hearing, 
as well as Plaintiff’s answers provided in two function reports that he completed in support 
of his applications for disability benefits. (Tr. at 1251–52, 1255–57, 384–95, 408–17.) 

Reviewing Plaintiff’s March 2024 hearing testimony, Plaintiff testified his social life is 
“[p]retty much non-existent” and involves shopping and seeing his parents. (Tr. at 1251.) 
He noted that he is able to do household chores and walk his dog, but that he cannot use a 
computer  and  finds  reading  difficult  because  of  mental  fogginess.  (Tr.  at  1251–52.) 
Plaintiff claimed that he did not think that he could perform the intellectual work needed 
to complete inventory-related tasks required by his previous work because he would have 
to read, be mentally clearheaded and organized, and interact with people. (Tr. at 1255.) He 

noted he particularly lacks the patience for social interactions, explaining, “I start shaking 
and [my] breathing gets out of whack,” and “I either have to go and try to isolate myself or 
I just have to leave . . . for the day.” (Tr. at 1255–56.) Plaintiff also testified that he received 
assistance from his parents with household tasks, finances and bills, tracking deadlines and 
paperwork, and prompts to remember to do things. (Tr. at 1257.)           

Function Reports                                                          
    A review of two function reports Plaintiff completed in October, 2020 and February, 
2021 shows that he lives alone without dependents, cares for a pet, performs his own 
personal care unprompted, prepares his own simple meals, does household chores, shops, 
does not drive, has trouble being in public because of anxiety and panic attacks, does not 

manage his own finances or pay his own bills, visits his parents regularly and texts with 
them daily, and receives help from his parents to remember medical appointments and 
attend them. (Tr. at 384–88, 409–13.) The forms indicate Plaintiff experiences impairments 
that affect talking, hearing, memory, completing tasks, concentration, and getting along 
with others, although he confirmed they do not impact his ability to understand or follow 

instructions. (Tr. at 389, 413.) Plaintiff noted that although he struggles to pay attention, 
he generally finishes what he starts, can follow instructions although he prefers to take 
notes to avoid forgetting steps, struggles to get along with authority figures, and does not 
tolerate stress or changes to his routine well. (Tr. at  389–90, 413–14.) Plaintiff also 
recounted his difficulty with weekly panic attacks, depression, and PTSD from a car 
accident that resulted in a traumatic brain injury (“TBI”) affecting his memory, ability to 
read, and pace to complete tasks. (Tr. at 392–93, 414–16.)                

    Together with the subjective evidence above, the ALJ also supported his review of 
the paragraph B criteria with objective medical evidence from various sources. Sources 
that the ALJ and parties focus on include these four medical providers:   
NP Kastanek                                                               
    Nurse  practitioner  (“NP”)  Rebecca  A.  Kastanek,  APRN,  CPN,  saw  Plaintiff 

between October 2018 through August 2020 to treat him for post-concussive syndrome 
and pain. (Tr. at 459–533.) She generally found his mood and affect normal and noted he 
had appropriate insight, but also documented that his post-concussive symptoms included 
mental fogginess and difficulty with concentration and memory. (Tr. at 462, 473, 502–03, 
509, 511, 522, 525, 533.)                                                 

Dr. Vandermay                                                             
    Psychologist  Julie  Anna  Vandermay,  PsyD,  MA,  performed  a  psychological 
assessment  of  Plaintiff  in  February  2019  upon  referral  from  Plaintiff’s  regular 
psychotherapist  who  expressed  concerns  about  Plaintiff’s  memory  issues,  ability  to 
remember instructions or complete tasks, and lack of motivation to perform activities of 

daily living. (Tr. at 934–45.) Dr. Vandermay found Plaintiff to have a good mood, logical 
thought process, appropriate attention and concentration, and an adequate memory to 
describe recent events. (Tr. at 936–37.) She administered a test measuring, among other 
things, his comprehension, reasoning, memory, and processing speed, and found that he 
scored average in comprehension, memory, and processing speed, and very superior in his 
perceptual reasoning. (Tr. at 937–38.) As to his attention, Dr. Vandermay noted that his 
scores were variable, and he demonstrated memory and information organization and 

retrieval difficulty with below average recall of verbal information in some contexts. (Tr. 
at 938–40.) Dr. Vandermay also found that Plaintiff struggled to focus and concentrate on 
some tasks like scanning and basic processing of information, particularly with complex 
information. (Tr. at 938.) As to his processing speed, Dr. Vandermay concluded that 
Plaintiff could perform brief verbal and visual tasks that involved basic processing, but that 

as tasks moved from simple to more complex, he showed slowing rates indicating greater 
difficulty with cognitive processing. (Tr. at 938–39.) She also observed that Plaintiff 
appeared to have mild to moderate limitations in his ability to interact socially. (Tr. at 942.) 
Dr. Sebas                                                                 
    John A. Sebas, MD, saw Plaintiff between November 2021 and December 2023 for 

a variety of physical and mental medical complaints, including dizziness and depression. 
(Tr. at 1496–1537.) Dr. Sebas noted that Plaintiff had a history of decreased memory and 
ordered a magnetic resonance imaging test (“MRI”) of Plaintiff’s head, observing that the 
last MRI had been in 2018 and had been unremarkable. (Tr. at 1518; see also Tr. at 525–
27  (2018  MRI  results).)  If  this  second  MRI  occurred,  it  does  not  appear  in  the 

administrative record. Otherwise, Dr. Sebas found Plaintiff’s neurological and psychiatric 
examinations yielded generally normal results and he was regularly stable despite his 
mental illness. (Tr. at 1508, 1518, 1536.) For example, Dr. Sebas conducted an annual 
physical exam in November 2022 and found Plaintiff was relatively stable, although he 
noted Plaintiff was struggling with his emotions and concluded that Plaintiff should qualify 
for disability benefits. (Tr. at 1524.) The assessment also noted that Plaintiff continued to 
decline medication to treat his bipolar and schizoid personality disorders, and that he was 

“drinking heavily about once a week.” (Id.) In May 2022, Dr. Sebas noted that Plaintiff’s 
significant mental illness, isolation, and dependence on family who live next door suggest 
Plaintiff cannot work and should be on disability benefits. (Tr. at 1534.) 
LSW Webb                                                                  
    Licensed social worker (“LSW”) Jennifer Webb, MSW, LICSW, saw Plaintiff in 

September and October 2021, treating him for anger, anxiety, suicidality, isolation, and 
interpersonal problems. (Tr. at 1185–1209.) She found Plaintiff presented with an anxious, 
guarded, and irritable mood, obsessive and paranoid thinking, and poor long and short term 
memory. (Tr. at 1187.) Plaintiff reported to her that he wished to stop drinking but had 
been unable to stop, noting that previous attempts at sobriety had caused him to suffer from 

the “shakes.” (Tr. at 1188.) Plaintiff also noted that he had serious difficulty with social 
interactions. (Tr. at 1189.) LSW Webb diagnosed him with  the  following disorders: 
depressive, panic, personality, alcohol use, and cannabis use. (Tr. at 1190–91.) Based on 
these disorders, she noted his common symptoms included racing thoughts, significant 
panic  sometimes  causing  black  outs  with  little  warning,  and  antisocial  and  avoidant 

behaviors.  (Id.)  She  also  observed  that  Plaintiff  needed  to  improve  his  insight  and 
accountability, learn better ways to manage his mental health symptoms, and likely needed 
to address his substance use. (Tr. at 1191.) Tests that she administered showed that Plaintiff 
suffered from moderate depression and anxiety. (Id.) LSW Webb worked with Plaintiff to 
set some goals to manage his anger and outbursts and to reduce his substance use. (See, 
e.g., Tr. at 1203–04, 1207–08.)                                           
                          *    *    *                                    

    With this record in mind, the first question before the Court is whether the ALJ’s 
conclusions on Plaintiff’s paragraph B criteria rest on substantial support in the record, as 
the Commissioner argues they do. The substantial evidence in the record standard requires 
the Court to review both evidence that supports the ALJ’s conclusions, and evidence that 
detracts from it. See Montgomery v. O’Malley, 122 F.4th 1059, 1063 (8th Cir. 2024). There 

must be enough evidence supporting an ALJ’s conclusions that a reasonable mind would 
agree the decision makes sense—even if inconsistent conclusions could be reached—so 
long as the ALJ’s conclusion is one of the possible conclusions. Id. The Court has studied 
the record above and finds that the ALJ considered the mixed record showing Plaintiff had 
some normal and some diminished functional abilities across the four mental assessment 

areas. The ALJ’s conclusions represent, in the Court’s view, one conclusion a reasonable 
mind could reach based on this mixed record.                              
    Plaintiff disagrees with this finding. He focuses a significant portion of his brief on 
specific reasons why the Court should find that the ALJ’s conclusions are incongruous with 
the bulk of the evidence. The Court has examined the record closely and respectfully 

disagrees, addressing Plaintiff’s specific challenges below.              
    1.   Substantial  evidence  in  the  record  as  a  whole  supports  the  ALJ’s 
         conclusion that Plaintiff has at-most moderate functional limitations in 
         the area of understanding, remembering, or applying information. 

    Plaintiff argues the ALJ wrongly concluded that Plaintiff has moderate limitations 
in understanding, remembering, or applying information. While noting that Plaintiff lives 
independently with some parental reliance, Plaintiff claims that the ALJ then inconsistently 
observed that Plaintiff depends on his parents for basic activities like shopping. Although 
Plaintiff claims this is an inconsistency, the Court respectfully disagrees. Having reviewed 
the record above, the Court finds the evidence is mixed on how independently Plaintiff 
functions, and it is true that he lives alone and also true that he relies on his parents for 
some activities like paying his bills.                                    
    Plaintiff similarly argues the ALJ wrongly concluded that Plaintiff has moderate 
limitations in understanding,  remembering,  or applying information  by  distorting the 
record to downplay specialist-derived evidence while amplifying more general findings 

from nonspecialists. He argues that the ALJ downplayed Dr. Vandermay’s highly relevant 
psychological  assessment  finding  that  Plaintiff  struggled  with  his  working  memory, 
impacting his ability to be attentive and focused. Plaintiff contends that to justify an at-
most moderate limitation, the ALJ focuses on mental status exams from other providers 
like NP Kastanek. The Court disagrees that the ALJ’s analysis distorts the record. For one 

thing, the ALJ clearly considered Dr. Vandermay’s report when  weighing Plaintiff’s 
functional abilities. (Tr. at 1225.) And NP Kastanek did not just find Plaintiff’s mental 
status examination to be normal once, she did so repeatedly in the record over several years, 
as noted above. Other providers did too, such as Michael Taylor Massey, DO, treating 
Plaintiff for low back pain, and Carrie LeBarron, PhD, LP, who assessed Plaintiff in a 
telehealth appointment. (See, e.g., Tr. at 1138, 1173.) While they may not have been 
extensively treating Plaintiff for his psychiatric function or may have seen him through 

telehealth appointments, their examination results still constitute relevant record evidence 
on Plaintiff’s memory, affect, and judgment. Taken together, the Court finds a reasonable 
mind  could  conclude  that  Plaintiff  retained  some  functional  ability  to  understand, 
remember, and apply information, even if he also had some limitations in these areas, 
resulting in a moderate limitation.                                       

    Plaintiff also claims that the ALJ ignored the effect Plaintiff’s history of concussions 
had on his functional ability to remember. However, the ALJ considered Plaintiff’s post-
concussive syndrome, yet found the record did not support that this was a medically 
determinable  impairment  because  it  was  not  a  consistently  formalized  diagnosis  for 
Plaintiff across providers. (Tr. at 1221.) The record suggests that some medical providers 

considered but ruled out post-concussion syndrome, while others appear to have treated 
Plaintiff for the condition. (See, e.g., Tr. at 83–84, 108–09, 113, 141, 459–533, 946.) The 
Court thus finds that while there is some evidence Plaintiff had experienced concussions 
and that some mental impairments related to understanding, remembering, and applying 
information might be attributable to post-concussive syndrome, it appears this was not a 

medical consensus and a reasonable mind could reach the conclusions that the ALJ did 
here.                                                                     
    Plaintiff also claims that the ALJ cherry-picked mental status examination results 
like those from LSW Kelsey R. Lynch that ignore the fact that suicidality was a continuous 
concern for Plaintiff, undermining his cognitive abilities. (Tr. at 1466–94.) He claims that 
while he may have shown appropriate attention, concentration, memory, insight, and 
judgment at such appointments, chronic daily thoughts of committing suicide undermine 

the ALJ’s conclusion that Plaintiff had only a moderate impairment in this area. (Tr. at 
1472, 1479, 1486, 1494.) The Court understands Plaintiff’s argument to be that thoughts 
of suicide establish a greater than moderate limitation in understanding, remembering, and 
applying information. This conclusion does not appear obvious to the Court, nor is it the 
Court’s role to interpret medical evidence and reach an administrative conclusion in place 

of an ALJ. The ALJ considered evidence of Plaintiff’s typically passive suicidal ideations 
in  his  opinion,  particularly  considering  the  effect  of  suicidal  thinking  on  Plaintiff’s 
functional ability to manage oneself. (Tr. at 1224, 1229–31.) While Plaintiff may wish that 
the  ALJ  had  reached  different  conclusions  about  the  effect  of  suicidal  thinking  on 
Plaintiff’s ability to understand, remember, and apply information, the Court finds that 

substantial evidence in the record as a whole supports the ALJ’s conclusion that Plaintiff 
had moderate limitations in this area. This remains true even if there is some evidence that 
suicidal thinking conflicts with that conclusion where the bulk of the evidence appears to 
support the ALJ’s conclusion. See Montgomery, 122 F.4th at 1063.          
    Plaintiff  also  argues  that  the  ALJ  failed  to  listen  to  at  least  one  medical 

professional’s  opinion  that  Plaintiff  should  qualify  for  disability  benefits.  The  ALJ 
acknowledged Dr. Sebas’s medical opinion on this point but disregarded his conclusions 
as “neither inherently valuable nor persuasive” because they reached “an ultimate issue 
reserved to the Commissioner.” (Tr. at 1232.) The Court agrees that this was proper 
because whether an SSA claimant is disabled is an administrative determination only the 
Commissioner can make. See Social Security Ruling (“SSR”) 96-5p, 1996 WL 374183, at 
*2 (S.S.A. July 2, 1996) (observing the difference between medical issues about the nature 

and severity of a claimant’s impairments, which are for medical professionals to determine, 
contrasted with administrative issues such as a claimant’s RFC, whether they can do their 
past work, or whether they are disabled, which are administrative findings reserved to the 
Commissioner); see also Jolene J.-D. v. O’Malley, No. 23-cv-2297 (JMB/DLM), 2024 WL 
3488001, at *6 n.8 (D. Minn. July 1, 2024) (“a medical professional may not translate their 

medical opinion or findings into the ultimate vocationally relevant limitation—that a 
person can or cannot work based on their evaluated impairments—because that opinion or 
finding  would  be  disregarded  as  encroaching  on  a  determination  reserved  to  the 
Commissioner of Social Security”), R. & R. adopted, 2024 WL 3470786 (D. Minn. July 
19, 2024).                                                                

    2.   Substantial  evidence  in  the  record  as  a  whole  supports  the  ALJ’s 
         conclusion that Plaintiff has at-most moderate functional limitations in 
         the area of social interaction.                                 

    Turning to the ALJ’s conclusions about Plaintiff’s moderate limitation interacting 
with others, Plaintiff claims the ALJ underestimated Plaintiff’s level of limitation. Plaintiff 
points to evidence from Dr. Vandermay’s February 2019 evaluation showing he struggles 
with emotional control and has significant emotional dysfunction, including that he may 
have temper tantrums and other anger-related problems that would result in a greater level 
of limitation. Yet the ALJ considered Plaintiff’s issues related to  “anger,  irritability, 
anxiousness and panic and anxiety attacks especially in public settings and interactions 
with  others,”  but  found  that  other  record  evidence  such  as  normal  mental  status 
examinations, his ability to spend time with his parents, and his ability to shop in stores 
showed a greater level of limitation was not justified. (Tr. at 1223–24.)  

    Plaintiff also asks the Court to consider evidence from Dr. LeBarron who found 
Plaintiff struggles with communication because of cognitive slippage and suffers from a 
social anxiety disorder. (Tr. at 1176, 1179.) But Plaintiff “denied the symptoms of social 
anxiety” to Dr. LeBarron, noted that “his parents are his next door neighbors,” and stated 
that he had been in a relationship for five years. (Tr. at 1172.) There is thus sufficient 

evidence to support the ALJ’s conclusion that, while moderate limitations were present, 
greater limitations were not indicated.                                   
    3.   Substantial  evidence  in  the  record  as  a  whole  supports  the  ALJ’s 
         conclusion that Plaintiff has at-most mild functional limitations in the 
         area of concentration, persistence, and pace.                   

    As to concentration, persistence, and pace, Plaintiff objects to the ALJ’s conclusion 
that Plaintiff had only a mild limitation in this area. Plaintiff argues that the ALJ failed to 
ask questions pertaining to this area in the hearing, then used Plaintiff’s silence to support 
only a mild functional limitation. While this critique is fair, the ALJ’s opinion does not 
appear to use Plaintiff’s silence on this topic at the hearing against him. The ALJ instead 
points out that, even though the topic was not covered at the hearing, he found that evidence 
elsewhere  in  the  record  supported  a  conclusion  that  concentrating,  persisting,  and 
maintaining pace would present some challenges for Plaintiff.             
    Plaintiff again points to Dr. Vandermay’s February 2019 psychological assessment 
discussed above, noting that she found Plaintiff had variable executive functioning skills, 
difficulty taking initiative to begin tasks or activities, and trouble thinking through and 
carrying  out  tasks  with  multiple  steps.  (Tr.  at  940–41.)  While  this  is  accurate,  Dr. 
Vandermay’s assessment also found precisely what the ALJ pointed out: that Plaintiff 

scored in the average range for comprehension, memory, and processing speed, and very 
superior in his perceptual reasoning. (Tr. at 937–38.) And the ALJ accurately pointed to 
other parts of the record showing that Plaintiff’s mental status exam results rarely reflected 
problems  with  attention  or  concentration  across  different  providers,  as  previously 
discussed. On this record, a reasonable mind might conclude that while Plaintiff had some 

limitations in his ability to concentrate, persist, or maintain pace, they were not so severe 
to exceed a moderate limitation. While Plaintiff asks the Court to consider the evidence 
and  determine  that  Dr.  Vandermay’s  test  results  demonstrate  at  least  two  “marked” 
limitations that would alter the ALJ’s analysis of Plaintiff’s paragraph B criteria and of 
related mental health listings,4 this amounts to a request to reweigh the evidence which the 

Court is not permitted to do. See Austin, 52 F.4th at 731 (“Whether the ALJ should have 
provided additional limitations amounts to a disagreement over the weighing of evidence 
within the record, and ‘it is not this Court’s role to reweigh that evidence.’”) (quoting 
Schmitt v. Kijakazi, 27 F.4th 1353, 1361 (8th Cir. 2022)).                





4 The term “listing” refers to step three in an ALJ’s analysis in which they determine 
whether a claimant’s impairments are severe enough to equal a listed impairment under 
Appendix 1 to Subpart P of Part 404. 20 C.F.R. §§ 404.1520(a)(4)(iii), 416.920(a)(4)(iii). 
    4.   Substantial  evidence  in  the  record  as  a  whole  supports  the  ALJ’s 
         conclusion that Plaintiff has at-most moderate functional limitations in 
         the area of adapting and managing oneself.                      

    Turning lastly to Plaintiff’s disagreement with the ALJ’s conclusions about his 
moderate limitation in adapting and managing oneself, Plaintiff claims the ALJ made an 
unsupported claim that Plaintiff’s providers did not recommend more intensive treatments 
for him. In fact, he argues, Dr. LeBarron suggested Plaintiff should consider occupational 
therapy, eye movement desensitization reprocessing therapy (“EMDR”), or an adult day 
treatment program. This is accurate and, in fact, Dr. LeBarron recommended an even more 
comprehensive list of 12 recommendations. (Tr. at 1180–81.) The Court does note that 
while  some  recommendations  were  listed  in  the  imperative—such  as  “[i]mplement 
relaxation  strategies”  or  “[m]aintain  a  consistent  sleeping  and  eating  pattern”—most 
recommendations (including the therapeutic options that Plaintiff mentions) were phrased 
as options for Plaintiff to “consider.” (Id.) This hardly indicates that Dr. LeBarron thought 

Plaintiff should be immediately hospitalized or should clearly be attending an adult day 
program because of the severity of his lack of self-care.                 
    Plaintiff also argues that the ALJ disregarded Dr. Vandermay’s conclusions about 
Plaintiff’s  deficits  in  self-management  involving  limitations  managing  interpersonal 
interactions, as well as limitations managing multi-step tasks accompanied by difficulty 

holding the “big picture” in mind. (Tr. at 942–43.) Like Dr. LeBarron, Dr. Vandermay also 
listed recommendations in her evaluation, including that Plaintiff consider individual and 
group therapy, medications, and strengthening his executive function skills, among other 
things. (Tr. at 945.) While both Dr. LeBarron and Vandermay’s reports support that 
Plaintiff has some limitations in the area of adapting and managing oneself, and while both 
appear to suggest therapeutic supports to help Plaintiff increase his functional abilities, it 
is not the Court’s role to look afresh at their test results or clinical recommendations and 

draw its own conclusions. Rather, the Court’s role is to ask whether the entire record 
supports the moderate limitations the ALJ found in this functional area. The Court finds 
substantial  support in the record for the ALJ’s conclusions here that, while Plaintiff 
struggles with stress, changes to routine, emotional regulation, alcohol use, and suicidality, 
Plaintiff has declined medication, recognizes his need to keep a routine to manage himself, 

and  lives  alone  with  support  from  his  parents.  On  balance,  this  supports  the  ALJ’s 
conclusions, even if it could also support other conclusions. See Montgomery, 122 F.4th at 
1063.                                                                     
    In sum, after carefully considering Plaintiff’s arguments, the Court finds that a 
reasonable mind could agree with the ALJ’s conclusions on Plaintiff’s functional abilities 

under the paragraph B criteria, even if there is some evidence to the contrary concerning 
the difficulties Plaintiff has with these areas. The Court will next turn to how this sound 
evidentiary basis for the ALJ’s paragraph B conclusions impacts Plaintiff’s challenge to 
the vocational expert’s testimony.                                        
B.   Because substantial evidence in the record as a whole supports the ALJ’s 
    conclusion that Plaintiff has at-most moderate functional limitations stemming 
    from his mental impairments, the ALJ could rely on the vocational expert’s 
    testimony based on that substantial record evidence.                 

    Because the ALJ’s at-most moderate mental limitations are supported by substantial 
evidence in the record, the Court also concludes that expert testimony based on those 
limitations provides a sound basis upon which the ALJ rested his conclusions. Specifically, 
the ALJ asked the vocational expert to opine on available jobs given the RFC crafted for 
Plaintiff that relied on his paragraph B mental impairment limitation findings. (Tr. at 1259.) 

The vocational expert testified that Plaintiff could still perform at least three “light work” 
representative jobs, including as a housekeeper (DOT No. 323.687-014), mailroom clerk 
(DOT No. 209.687-026), and merchandise marker (DOT No. 209.587-034). (Id.) The ALJ 
then reduced the hypothetical exertional level to “sedentary work.”5 Again, the vocational 
expert identified three representative jobs: address clerk (DOT No. 209.587-010), account 

clerk (DOT No. 205.367-014),6 and bench sorter (DOT No. 521.687-086). (Tr. at 1259–
60.) The vocational expert added that she had personally observed all six occupations she 
had identified as they are currently performed, and that she could confirm that they would 
fit the ALJ’s hypothetical criteria. (Tr. at 1260–61.)                    
    Plaintiff asserts that because the ALJ failed to paint the full picture of Plaintiff’s 

mental impairments when posing hypotheticals to the vocational expert, the expert’s 
responses were likewise incomplete and do not constitute substantial evidence for the 

5 Sedentary work “involves lifting no more than 10 points at a time and occasionally lifting 
or carrying articles like docket files, ledgers, and small tools. Although a sedentary job is 
defined as one which involves sitting, a certain amount of walking and standing is often 
necessary in carrying out job duties. Jobs are sedentary if walking and standing are required 
occasionally and other sedentary criteria are met.” 20 C.F.R. §§ 404.1567(a), 416.967(a). 
6 The ALJ noted that for the account clerk role, the fifth digit representing the amount of 
social interaction with others required was a six,  as opposed to the least amount of 
interaction signified by the number eight for all of the other identified roles. (Tr. at 1260.) 
When questioned about whether this role’s social requirements would exceed Plaintiff’s 
limitations, the vocational expert explained that the role has changed over time with the 
advent of emails and form completion on a computer, no longer requiring someone to talk 
with others on more than an occasional basis. (Id.)                       
ALJ’s conclusions.7 “A vocational expert’s testimony constitutes substantial evidence 
when  it  is  based  on  a  hypothetical  that  accounts  for  all  of  the  claimant’s  proven 
impairments.” Hulsey v. Astrue, 622 F.3d 917, 922 (8th Cir. 2010) (citing Grissom v. 

Barnhart, 416 F.3d 834, 837 (8th Cir. 2005)). As discussed above, that was the case here. 
The hypothetical posed to the vocational expert was based on an appropriately tailored 
RFC, and it was not error for the ALJ to rely on the expert’s responsive testimony. The 
Court therefore finds that the ALJ did not commit any error at step five of the sequential 
analysis, nor did the ALJ disregard the SSA Appeals Council’s directive to base any 

hypothetical questions on the limitations established by the record as a whole. 
                            ORDER                                        
    Based on the above findings, as well as the files, records, and proceedings above, 
IT IS ORDERED that:                                                       
    1.   Plaintiff’s request for reversal (Doc. 5) is DENIED; and        

    2.   The Commissioner’s request for affirmance (Doc. 8) is GRANTED.  
    LET JUDGMENT BE ENTERED ACCORDINGLY.                                 

DATED:    July 22, 2025              s/Douglas L. Micko                   
                                  DOUGLAS L. MICKO                       
                                  United States Magistrate Judge         


7 Plaintiff was represented by the same attorney at his hearing before the ALJ and in this 
action, but counsel did not ask the vocational expert any questions about Plaintiff’s mental 
limitations. (Tr. at 1262-65.) While not determinative, it is difficult to harmonize Plaintiff’s 
critique that the ALJ asked myopic hypothetical questions to the vocational expert when 
Plaintiff’s counsel—given the opportunity—did nothing to increase the aperture.