MEMORANDUM OPINION? Plaintiff Renae Leona Lacaille (“Plaintiff”) filed this action pursuant to 42 U.S.C. § 405(g) against defendant Kilolo Kijakazi, the Acting Commissioner of the Social Security Administration (the ““Commissioner”), seeking judicial review of the Commissioner’s final decision denying Plaintiff's claim for supplemental security income (“SSI”) under Title XVI of the Social Security Act (the “Act”), 42 U.S.C. §§ 1381-1383f. (D.L. ^[2]) Currently before the court are cross-motions for summary judgment filed by Plaintiff and the Commissioner? (D.I. 12; D.I. 14) For the reasons set forth below, I recommend that the court GRANT Plaintiff's motion for summary judgment (D.I. 12), DENY the Commissioner’s cross-motion for summary judgment (D.I. 14), and remand the case for further proceedings.

' Kilolo Kijakazi became the Acting Commissioner of Social Security on July 9, 2021. Therefore, pursuant to Rule 25(d) of the Federal Rules of Civil Procedure, Ms. Kijakazi is substituted as Defendant in place of Andrew Saul. March 28, 2022, the parties consented to the jurisdiction of a magistrate judge to conduct all proceedings in this matter through final judgment, pursuant to 28 U.S.C. § 636(c). (D.I. 19) 3 The briefing on the pending motions is found at D.I. 13 and D.I. 15. On December 8, 2021, Plaintiff filed a notice of her intention to rest on her opening brief without further briefing. (D.L. 16)

I. BACKGROUND A. Procedural History Plaintiff protectively filed a claim for SSI on January 30, 2018, alleging disability as of November 18, 2013 due to bipolar disorder, depression, anxiety, post-traumatic stress disorder, high blood pressure, asthma, arthritis in both knees and legs, back and shoulder pain, and eczema. (D.I. ^[9] at 85-86, 192) Plaintiff's claims were denied initially in June 2018 and upon reconsideration in April 2019. (Ud. at 84, 105) At Plaintiff's request, an administrative law judge (“ALJ”) held a hearing on June 1, 2020. (/d. at 43-59) The ALJ issued an unfavorable decision on June 12, 2020, finding that Plaintiff was capable of a limited range of light work. (/d. at 21- 34) The Appeals Council subsequently denied Plaintiff’s request for review, making the ALJ’s decision the final decision of the Commissioner. (/d. at 7-9) Plaintiff brought this civil action on June 7, 2021. (D.I. ^[2]) Plaintiff filed the pending motion for summary judgment on November 5, 2021 (D.I. 12), and the Commissioner cross- moved for summary judgment on December 2, 2021 (D.I. 14). Briefing is now complete on the pending motions. B. Medical History Plaintiff was 33 years old when she filed her application for SSI benefits on January 30, 2018. (D.I. ^[9] at 33) The ALJ found that Plaintiff had the following severe impairments: cervicalgia, lower back pain, obesity, bipolar disorder, and an intellectual disability. (id. at 23) The court focuses its summary of the medical evidence on the records relevant to Plaintiff's mental impairments, which are the subject of Plaintiff's appeal.

If the claimant’s impairments are severe, at step three, the Commissioner compares the claimant’s impairments to a list of impairments that are presumed severe enough to preclude any gainful work. See id. at § 416.920(a)(4)(iii); Plummer, 186 F.3d at 428. When a claimant’s impairment or its equivalent matches a listed impairment, the claimant is presumed disabled. See 20 C-F.R. § 416.920(a)(4)(iii). If a claimant’s impairment, either singly or in combination, fails to meet or medically equal any listing, the analysis continues to steps four and five. See id. at § 416.920(e). At step four, the ALJ considers whether the claimant retains the residual functional capacity (“RFC”) to perform past relevant work. See id. at § 416.920(a)(4)(iv); Plummer, 186 F.3d at 428. A claimant’s RFC “measures the most she can do despite her limitations.” Zirnsak v. Colvin, 777 F.3d 607, 611 (3d Cir. 2014) (quoting 20 C.F.R. § 404.1545(a)(1)) (internal quotations and alterations omitted). The claimant bears the burden of demonstrating the inability to return to past relevant work. See Plummer, 186 F.3d at 428. If the claimant is unable to return to past relevant work, at step five, the Commissioner must demonstrate that the claimant’s impairments do not preclude an adjustment to any other available work. See 20 C.F.R. § 416.920(g); Plummer, 186 F.3d at 428. In other words, the Commissioner must prove that “there are other jobs existing in significant numbers in the national economy which the claimant can perform, consistent with her medical impairments, age, education, past work experience, and [RFC].” Plummer, 186 F.3d at 428. The ALJ must analyze the cumulative effect of all the claimant’s impairments in determining whether he or she is capable of performing work and is not disabled. See id. The ALJ often seeks the VE’s assistance in making this finding. See id.

B. Whether the ALJ’s Decision is Supported by Substantial Evidence Plaintiff argues that the ALJ failed to properly assess the consistency and supportability of the medical opinion evidence regarding her mental impairments. (D.I. 13 at 8-18) According to Plaintiff, the ALJ’s inadequate evaluation of these medical opinions led to a deficient RFC assessment, and remand is therefore required. (Jd.) For the following reasons, the court concludes that the ALJ’s assessments of the opinions of Plaintiff's treating providers, consultative examiner Dr. Simon, and the State agency physicians were supported by substantial evidence. ^[1]. Assessment of opinion evidence from treating providers Plaintiff contends that the ALJ erred in finding the opinions proffered by Ms. Peterson, Ms. Cleary, and Mr. Cantor unpersuasive because these opinions were consistent with each other and were supported by the providers’ underlying treatment records. (D.I. 13 at 9-11, 15-16) Because the opinions of Plaintiff's treating providers support greater limitations than those included in the ALJ’s RFC, Plaintiff contends that the error is not harmless, and remand is

required. (/d. at 8-9, 17) In accordance with the revised regulatory framework for claims filed on or after March 27, 2017, the ALJ is not required to give any “specific evidentiary weight, including controlling weight, to any medical opinion(s) . . . , including from a medical source.” 20 C.F.R. § 416.920c(a). Instead, the ALJ must consider the persuasiveness of all medical opinions based on the application of five factors: (1) supportability; (2) consistency; (3) relationship with the claimant; (4) specialization; and (5) other factors. Id. at § 416.920c(a)-(c). The ALJ must explain how he considered the most important factors of supportability and consistency. Id. at § 416.920c(b)(2). “Consistency concerns the degree to which the opinion reflects the same limitations described in evidence from other sources, whereas supportability concerns the relevancy of objective medical evidence and degree of explanation given by the medical source to support the limitations assessed in the opinion.” Eader v. Saul, 2020 WL 10898140, at *3 (M.D. Pa. Nov. 20, 2020) (internal quotation marks and citations omitted). Here, the ALJ acknowledged that Ms. Cleary, Ms. Peterson, and Mr. Cantor, “issued opinions overall consistent with one another,” but he found that those opinions were not supported by their own treatment notes. (D.I. ^[9] at 30) In support of this finding, the ALJ observed that “[t]he claimant has consistently reported her medication regimen has controlled her symptoms, and she has displayed no issues or difficulties attending appointments as scheduled or taking her medications as prescribed.” (/d.) While the underlying records confirm that Plaintiff was receptive to treatment and benefited from her medications, the ALJ did not acknowledge treatment records from Ms. Cleary identifying lapses in Plaintiff's medication regimen. In March 2019, Ms. Cleary diagnosed Plaintiff with “Nonadherence to Medical Treatment,” explaining that Plaintiff reported taking her medications consistently despite the fact that she “should have run out of meds” by that time. ^[9] at 710) Again in August 2019, Ms. Cleary noted that Plaintiff ran out of medication and “has been stretching meds.” (/d. at 843-44) Ms. Cleary’s notes indicate that when Plaintiff ran out of medication, she felt “discombobulated.” (/d. at 615) In this regard, the ALJ’s assessment that the treatment records showed “no issues or difficulties . . . taking her medications as prescribed” is inaccurate. (/d. at 30) More critically, the ALJ concluded that the opinions of Ms. Cleary, Ms. Peterson, and Mr. Cantor were unpersuasive based on his finding that their treatment notes showed Plaintiff “has not displayed limited attention, concentration, or ability to complete tasks presented to her.”

(D.I. ^[9] at 30) This assessment is not supported by Plaintiff's treatment records. Ms. Cleary routinely reported that Plaintiff exhibited rambling speech and racing thoughts, and she often felt overwhelmed and frustrated. (/d. at 617, 622, 691, 844, 851, 866) These aspects of Ms. Cleary’s treatment records support her opinion that Plaintiff's racing thoughts, and the ease with which she became frustrated and overwhelmed, would prevent Plaintiff from working full-time. (/d. at 600-02, 873-75) Ms. Peterson’s treatment notes from 2018 establish that Plaintiff often required Ms. Peterson’s assistance in completing and transmitting paperwork. (D.I. ^[9] at 625, 629) At least twice, Plaintiff dropped in without a scheduled appointment to seek Ms. Peterson’s help in completing paperwork. (/d. at 631, 633) On these occasions, Ms. Peterson observed Plaintiff's agitation, heightened anxiety, and frustration. (id) These records support Ms. Peterson’s opinion that Plaintiff would be limited in her ability to sustain work performance, cope with the pressures of ordinary work, understand and carry out simple instructions, and perform routine, repetitive tasks. (/d. at 596-97) In April 2019, Mr. Cantor described Plaintiff's mood as “labile,” and his treatment notes from December 2019 indicated that Plaintiff “is active in many areas of her life; but needs help focusing on her many daily tasks.” (id. at 825, 854) In January 2020, he reported that Plaintiff exhibited “hyper verbal, rambling speech, struggling to stay focused.” (/d. at 863) These portions of Mr. Cantor’s records support his opinion that Plaintiff would have difficulty remaining on task throughout the workday due to her mood swings and difficulty concentrating. (id, at 870) Because the ALJ’s characterization of Plaintiff's treatment records is factually inaccurate, the ALJ’s justification for finding the opinions of Ms. Cleary, Ms. Peterson, and Mr. Cantor unpersuasive under the supportability factor is flawed. See Andrews v. Kijakazi, 2022 WL 617118, at *8 (M.D. Pa. Mar. ^[2], 2022) (concluding that ALJ’s decision was not supported by substantial evidence where his reasons for finding medical opinion persuasive were factually inaccurate). For this reason, the ALJ’s decision is not supported by substantial evidence, and remand is required for reconsideration of the supportability factor as it pertains to the opinions of Ms. Cleary, Ms. Peterson, and Mr. Cantor. See Gamret v. Colvin, 994 F. Supp. 2d 695, 698 (W.D. Pa. 2014) (“Even if enough evidence exists in the record to support the decision, [the court] cannot uphold it if the reasons given by the trier of fact do not build an accurate and logical bridge between the evidence and the result.” (internal citations and quotation marks omitted)). 2. Assessment of evidence from consultative examiner Plaintiff correctly contends that the ALJ erred by failing to address Dr. Simon’s opinion that Plaintiff “may encounter some problems . . . being able to persist for a normal work period because of her psychiatric problems.” (D.I. ^[9] at 528; D.I. 13 at 12-13) The ALJ acknowledged Dr. Simon’s opinion that Plaintiff had “moderate limitations . . . sustaining work performance” and found Dr. Simon’s opinions persuasive. (D.I. ^[9] at 29) Nonetheless, the ALJ did not account for any limitations on Plaintiffs ability to complete a normal work period in his RFC assessment. (/d. at 27) The ALJ’s failure to account for the limitation in his RFC assessment or elsewhere in his opinion prevents the court from ascertaining whether the ALJ did not credit this portion of the opinion or simply ignored it. See Burnett v. Comm’r of Soc. Sec. Admin., 220 F.3d 112, 121 Gd Cir. 2000). Plaintiff's second argument regarding Dr. Simon’s alleged failure to review Plaintiff’ medical records is not supported by the record. (D.I. 13 at 13) Dr. Simon’s opinion expressly acknowledges that he received Plaintiff's medical records along with her referral note. (D.I. ^[9] at 526) Because the ALJ will be required to reassess the opinions of Dr. Simon and Plaintiff's treating providers on remand, the court need not reach Plaintiff's argument regarding the level of persuasion accorded to each of the opinions. (D.I. 13 at 13) Similarly, Plaintiff's third argument regarding the alleged stability of Plaintiff's mental health symptoms during the relevant period may be impacted by the ALJ’s reconsideration of portions of the record on remand in accordance with the court’s rulings at §§ TI.B.^[1] and 2. 3. Assessment of State agency administrative findings Plaintiff argues that the ALJ erred in crediting the reports of two non-examining State agency psychologists over the opinions of her treating providers. (D.I. 13 at 14-15) In particular, Plaintiff challenges the ALJ’s representation that the State agency psychological consultants possess “a comprehensive understanding of agency rules and regulations.” (Ud; D.I. ^[9] at 32) But this was not the only—or even the primary—factor considered by the ALJ in determining that the opinions of the State agency consultants were persuasive. The ALJ also focused on the State agency consultants’ thorough review of the available medical record, the opinions’ internal consistency, and the fact that the opinions were “well supported by a reasonable explanation and the available evidence at the time of their determinations, including .

.. the rather stable, benign findings on mental status examinations on a stable medication regimen throughout the relevant period.” (D.I. ^[9] at 32) Thus, the ALJ did not err by also noting that the State agency consultants possess “a comprehensive understanding of agency rules and regulations.” (/d.)

IV. CONCLUSION For the foregoing reasons, Plaintiff's motion for summary judgment (D.I. 12) is GRANTED, and the Commissioner’s cross-motion for summary judgment (D.I. 14) is DENIED. This matter shall be remanded for further proceedings. On remand, the ALJ shall reevaluate the supportability factor as it pertains to the opinions of Ms. Cleary, Ms. Peterson, and Mr. Cantor, and shall address Dr. Simon’s opinion that Plaintiff had moderate limitations in sustaining work performance. An Order consistent with this Memorandum Opinion shall issue.

Dated: September 30, 2022 -- A | { A Lx ) erry R. Fall United States Magistrate Judge