Hurst v. Commissioner of Social Security

1
IN THE UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF OHIO
EASTERN DIVISION
JUSTINA HURST o/b/o G.J.D.A.,
Plaintiff,
vs.
COMMISSIONER OF SOCIAL
SECURITY,
Defendant.
CASE NO. 5:25-cv-1244
DISTRICT JUDGE
CHARLES ESQUE FLEMING
MAGISTRATE JUDGE
JAMES E. GRIMES JR.
REPORT AND
RECOMMENDATION
Plaintiff Justina Hurst filed a complaint against the Commissioner of
Social Security on behalf of her son, G.J.D.A., seeking judicial review of the
Commissioner’s decision denying their application for supplemental security
income. Doc. 1. This Court has jurisdiction under 42 U.S.C. §§ 405(g) and
1383(c). The Court referred this matter to a Magistrate Judge under Local Rule
72.2(b)(1) for the preparation of a Report and Recommendation. Following
review, and for the reasons stated below, I recommend that the District Court
affirm the Commissioner’s decision.
Case: 5:25-cv-01244-CEF Doc #: 12 Filed: 02/09/26 1 of 22. PageID #: <pageID>

2
Procedural Background
In January 2023, Hurst filed an application for supplemental security
income on behalf of her son, G.J.D.A., alleging a disability onset date of
December 19, 2021.1 See Tr. 178, 202. Hurst alleged disability due to: “ADHD-
2016 *trouble focusing *needs aide with him in classrooms sensory process
disorder- 2017 depression – 2017 anxiety – 2017 *headaches manic bipolar
disorder -2020 *has gotten into fights at school.” Tr. 205. The Commissioner
denied Hurst’s application initially and on reconsideration. See Tr. 76, 82.
In August 2023, Hurst requested a hearing. Tr. 86. Administrative Law
Judge (“ALJ”) Brian Burgtorf held a telephonic hearing in May 2024. Tr. 32–
55. Hurst appeared, testified, and was represented by counsel at the hearing.
Tr. 37. G.J.D.A. also testified at the hearing. Tr. 50. Later in May 2024, the
ALJ issued a written decision, which found that G.J.D.A. was not entitled to
benefits. Tr. 14–31.
In June 2024, Hurst appealed the ALJ’s decision to the Appeals Council.
Tr. 171. In April 2025, the Appeals Council denied Hurst’s appeal, Tr. 1,
making the ALJ’s May 2024 decision the final decision of the Commissioner.
Tr. 14–31; see 20 C.F.R. § 404.981.
1 	“Once a finding of disability is made, the [agency] must determine the
onset date of the disability.” McClanahan v. Comm’r of Soc. Sec., 193 F. App’x
422, 425 (6th Cir. 2006).
Case: 5:25-cv-01244-CEF Doc #: 12 Filed: 02/09/26 2 of 22. PageID #: <pageID>

3
Medical Evidence
The ALJ summarized the undisputed medical evidence as follows:
The claimant's mother reported that the claimant
was disabled due to ADHD, with trouble focusing
and 	needing 	help 	in 	the 	classroom, 	sensory
processing disorder, depression, anxiety, headaches,
and manic bipolar disorder with episodes of fighting
at 	school 	(Exhibit 	2E). 	The 	claimant’s 	mother
further reported that the claimant decompensated
without a routine (Exhibit 3E). Additionally, he was
limited in his ability to communicate, as he could not
answer the telephone and make telephone calls;
deliver phone messages; repeat stories he had heard;
tell jokes or riddles accurately; use sentences with
“because,” “what if,” or “should have been”; or talk
with friends (Exhibit 3E). He also had limitations in
his ability to read and understand sentences, comics,
and cartoons; read and understand stories, books,
magazines, and newspapers; spell words of more
than four letters; multiply and divide numbers over
10; understand money and make correct change; and
understand, carryout, remember simple instructions
(Exhibit 3E).
The claimant had limitations in his ability to ride a
bike, jump rope, and play sports. He did not have
friends his or her own age, he had difficulty making
friends, he did not generally get along well with
siblings, and he did not play team sports because he
had major meltdowns if he lost. He had difficulty
taking 	care 	of 	personal 	hygiene, 	washing 	and
putting away clothing, helping around the house,
preparing a meal for himself, studying and doing
homework, taking needed medication, using public
transportation by himself, accepting criticism or
correction, obeying rules, and asking for help when
needed. He had difficulty working arts and craft
projects, 	finishing 	things 	he 	started, 	completing
homework, 	completing 	homework 	on 	time, 	and
completing chores most of the time as he would not
voluntarily sit and do any work. The claimant’s
mother 	further 	reported 	that 	the 	claimant 	was
Case: 5:25-cv-01244-CEF Doc #: 12 Filed: 02/09/26 3 of 22. PageID #: <pageID>

4
taking four different medications to help with focus
and 	staying 	calm. 	However, 	he 	still 	had 	much
anxiety that overtook his mood and he could not stay
focused 	and 	calm, 	and 	he 	got 	upset 	sometimes
(Exhibit 3E).
At the hearing, the claimant’s mother testified that
the claimant has ADHD and prior to medication
management, he was a little more violent when he
was overwhelmed, agitated, or frustrated. He does
not like to wait his turn and he does not like to wait
in line. He throws things and punches walls. He
sometimes does not remember anger outbursts. He
is 	not 	as 	violent 	with 	medication, 	but 	says
aggressive and inappropriate things. He broke two
televisions, 	a 	video 	game 	console, 	and 	several
telephones. He cannot ride a bike, he cannot tie his
shoes, he cannot button his pants. He does not brush
his teeth, he does not shower unless told, and he does
not brush his hair. He does not choose his own
clothes. He does not do chores, but will help take out
the trash. He can get snacks that do not require
cooking. He is never at home alone. He does not do
well in school and generally always earned Ds and
Fs. 	He 	refuses 	to 	do 	the 	work. 	He 	is 	still
participating in counseling at school, which helps
with his missing father issues. He has migraine
headaches 	as 	a 	side 	affect 	from 	Adderall, 	and
Compazine makes him sluggish. He has migraine
headaches two or three times a month. Dr Bromberg
indicated he could try a different medication, but
they declined to change it. The claimant testified
that 	he 	likes 	to 	play 	outside 	for 	fun 	and 	play
basketball 	on 	a 	hoop 	in 	the 	driveway. 	He 	also
watches basketball on television. He likes numbers,
so his favorite subject at school is math. He has a
friend named Carter at Success class. His favorite
book he read is the Hunger Games. He does not do
chores because he does not want to.
An unsigned and undated teachers questionnaire
when the claimant was in seventh grade, showed
that 	he 	missed 	22 	days 	of 	school 	and 	he 	had
accommodations (Exhibit 4F). Responses to the form
Case: 5:25-cv-01244-CEF Doc #: 12 Filed: 02/09/26 4 of 22. PageID #: <pageID>

5
indicated the claimant had only a slight problem in
acquiring and using information; and he began his
assignments 	independently 	and 	worked 	ahead.
Additionally, if he fell behind due to absences he
benefited from the use of checklists to get missing
work completed. The claimant had slight to obvious
problem with attending and completing tasks, with
the comment that he had shown improvement with
staying on top of his assignments and using a binder
to be reminded to turn in his work. He had no
problems interacting and relating with others, no
problems moving about and manipulating objects,
and no problems caring for himself. The teacher
noted that the claimant was motivated to complete
work at school and was socializing more when he
was taking his medication, but he frequently missed
school and did not make up all missing work.
The claimant’s 8th-grade teacher stated that the
claimant had a slight problem in acquiring and
using 	information 	as 	he 	got 	additional 	time 	to
complete assignments and 50-minute resource time
with a low student to teacher ratio and he received
additional time 	for testing and quizzes 	(Exhibit
13E). Additionally, the claimant had a slight to
moderate 	problem 	in 	his 	ability 	to 	attend 	and
complete tasks, but he benefited from prompting for
work completion and remaining on task (Exhibit
13E).
Psychiatry outpatient progress notes from February
12, 2020, show that the claimant was doing well on
medication although it wore off at 2 pm and he was
not sure about the effect of his medication (Exhibit
6F-2). He also reported that his mood worsened
when he was upset/frustrated/disappointed, but did
not discuss further why this occurred. Instead, he
became silly, joked and avoided further questions.
The mental status examination on May 12, 2020,
showed 	cooperative 	behavior 	with 	okay 	mood,
constricted 	and 	flat 	affect, 	age-appropriate 	and
intact attention span/concentration, average fund of
knowledge/estimated 	intelligence, 	and 	age-
appropriate judgment and insight (Exhibit 6F-10).
Case: 5:25-cv-01244-CEF Doc #: 12 Filed: 02/09/26 5 of 22. PageID #: <pageID>

6
The claimant’s mental health care provider, Daniela
Marcella- Bromberg, MD, noted on September 14,
2021, that the claimant was doing the best that he
had in years and he had not had behavioral or mood
problems in months (Exhibit 6F-25). Additionally,
his medication was helping with his moods and he
had not had problems with anger or depression in a
while. He was not very active and he liked to be by
himself; and sometimes he was apathetic about
activities in general. He did poorly with changes in
routine and his family has adapted to his needs and
he 	spent 	most 	of 	his 	time 	living 	with 	his
grandmother who lived two blocks away from his
mother.
On December 8, 2021, around the claimant’s alleged
onset of disability, mental health treatment notes
from 	the 	claimant’s 	psychiatrist, 	Dr. 	Bromberg,
indicated that the claimant’s mom reported he was
still doing very good, she denied any mood problems
or behavioral problems, and he was doing good at
school with getting good grades (Exhibit 6F-30). He
was sleeping well with medication and his appetite
was good, and she denied safety concerns. It was
noted that he lived with his mother, her boyfriend,
his younger toddler sister, and his older sister; but
generally 	spent 	much 	of 	his 	time 	in 	his
grandmother’s house because he had lived there
prior to the Summer of 2020, and it gave him a sense
of stability. Additionally, treatment notes show that
the 	claimant 	continued 	to 	do 	well 	with 	few
complaints in March 2022 (Exhibit 6F-34).
Treatment 	notes 	from 	Greenlee 	Family 	Center,
dated May 4, 2022, indicate that the claimant was
enrolled in school-based counseling services since
2016 and his mother reported that his behavior had
been 	stable 	and 	pleasant 	(Exhibit 	3F-1). 	She
reported that everything seemed to be working and
she wanted him to continue services through the
school year. In September 2022, after the claimant
returned 	to 	school 	and 	services, 	the 	claimant’s
mother reported major changes that affected his
Case: 5:25-cv-01244-CEF Doc #: 12 Filed: 02/09/26 6 of 22. PageID #: <pageID>

7
functioning, such as changing medication, lack of
contact with his father, and his sisters medically
complicated brain tumor that caused major concern
and anxiety in the family (Exhibit 3F-4). At that
time, the claimant’s mother reported that he was
better functioning and less angry, but he was failing
to 	give 	close 	attention 	to 	details, 	had 	difficulty
sustaining attention, often did not follow through on
instructions, 	disliked 	engaging 	in 	tasks 	that
required mental effort, was easily distracted and
often fidgeting, often left his seat, and did not appear
to listen when spoken to (Exhibit 3F-5). He was also
suspended recently for hitting a kid who would not
get out of his chair.
On November 14, 2022, mental health treatment
notes show that the claimant’s mother reported that
the claimant was having a difficult time in school
due to getting overwhelmed, per his IEP teacher but
he had run out of Adderall XR so he was getting only
Adderall at that time (Exhibit 6F-41). However, he
had improvement with return of his Adderall XR.
Additionally, 	he 	was 	not 	able 	to 	sit 	still 	and
concentrate at home and he did not want to do
homework; but he was not getting the full dose of
Adderall because his mother thought it was too
much Adderall. They also lost a bottle of Topamax a
few days ago and he had missed his dosage for two
days, but his mood and behavior had been good.
There was no concern for depression or anxiety and
he seemed to be in very good mood with no safety
concerns reported.
Psychiatric 	medication 	management 	treatment
notes from February 24, 2023, she indicated the
claimant was overall doing well, school was going
good, and his grades were improving as he was no
longer failing (Exhibit 6F-46). He was doing his
homework, but he would get distracted by other
students being disruptive. He had no new behavioral
problems and no new aggressive behaviors. There is
no concern for depression or anxiety with no safety
concerns, but he was still having some issues falling
asleep.
Case: 5:25-cv-01244-CEF Doc #: 12 Filed: 02/09/26 7 of 22. PageID #: <pageID>

8
On April 20, 2023, the claimant’s mother reported to
the claimant’s counselor that his behavior at school
had significantly improved but he still displayed
anger and defiant behavior at home (Exhibit 9F-14).
The 	claimant’s 	counselor 	referred 	a 	transfer 	of
services. but the claimant’s mother declined services
for the rest of the school year and summer and
wanted to resume beginning the next school year
September 2023 (Exhibit 9F-16).
At a consultative mental status examination on May
9, 2023, the claimant’s mother reported that the
claimant “had violent tendencies” (Exhibit 5F). She
further stated that his sister had to live with her
grandparents 	due 	to 	the 	claimant 	physically
attacking her. She further reported that he was
receiving outpatient mental health treatment with
Dr. Bromberg and he received medication services
but 	he 	had never received inpatient 	psychiatric
treatment. She also reported that he sometimes did
not sleep and he experienced mood instability with
mood swings, increased irritability, racing thoughts,
and engagement in risky and impulsive behaviors.
She reported that he did not sleep unless he took
medication. She reported that he had significant
motor skills delay, had been cruel to animals, wet
the bed, and urinated inappropriately in the house.
He was not able to hop on one foot or ride a bicycle;
he was not able to zip, button, or tie; and he required
supervision to complete his personal care and get
dressed appropriately. She reported that he got
along with others, “depending on his mood”, and he
had threatened her and his grandparents in the past
and he had been physically assaultive towards his
older sister. He got extremely upset if his routine
was changed for any reason and he had to eat dinner
at exactly 5 PM or he had a meltdown. She also
reported that he was struggling in school and his
grades 	were 	decent 	enough. 	He 	had 	also 	been
involved in fights at school and had been suspended.
She reported that he got angry and would “blackout
and not remember what he had done.” The claimant
reported that he threw stuff and hit walls and doors
Case: 5:25-cv-01244-CEF Doc #: 12 Filed: 02/09/26 8 of 22. PageID #: <pageID>

9
when he became angry and he became angry every
day. He also reported that he became violent when
he was angry.
The consultative mental status examiner, Claudia
Johnson – Brown, PhD, noted that the claimant had
poor hygiene and grooming and his motor activity
was observed to be greater than normal limits. He
was unable to sit quietly throughout the interview
and he was banging on doors and walls when his
mother was speaking with her. He was unable to
state his current address or his mother’s cell phone
number and he did not know the correct date. His
ability to concentrate appeared somewhat impaired,
but his immediate recall appeared intact. His recent
memory appeared intact and his remote memory
appeared significantly impaired. He attempted to be
pleasant and cooperative, but at times was angry
and 	irritable 	and 	his 	mood 	appeared 	somewhat
depressed. 	His 	affect 	was 	flat 	and 	somewhat
restricted, and he made normal eye contact. His
insight appeared fair to marginal and his judgment
appeared fair. Dr. Johnson – Brown found that the
claimant 	had difficulty 	academically 	keeping 	up
with 	same 	age 	peers, 	he 	had 	difficulty 	paying
attention 	and 	concentrating, 	he 	had 	difficulty
interacting 	with 	others, 	and 	had 	difficulty
completing 	his 	personal 	care. 	She 	assessed 	the
claimant with bipolar I disorder, autism spectrum
disorder, 	and 	attention 	deficit/hyperactivity
disorder.
However, on June 6, 2023, Dr. Bromberg noted that
the claimant was overall doing well, he did pretty
good in school and passed all of his classes with Cs
and 	Bs, 	and 	his 	ADHD 	symptoms 	were 	well-
controlled (Exhibit 6F-50).
A reevaluation of the claimant through his middle
school, dated September 14, 2023, indicated that the
claimant’s 	mother 	reported 	that 	the 	claimant
needed extra time to complete even small tasks due
to problems with focus and he would be overcome
with 	anger 	or 	anxiety 	when 	pushed 	or 	rushed
Case: 5:25-cv-01244-CEF Doc #: 12 Filed: 02/09/26 9 of 22. PageID #: <pageID>

10
(Exhibit 7F-5). She also reported he had trouble
managing his emotions. The claimant’s teachers
indicated that he was doing well and completing
assignments 	on 	time, 	he 	followed 	instructions
within the classroom, but he had difficulty with
showing his work in math and some difficulty in
writing (Exhibit 7F-6). Additionally, he sometimes
got distracted when working with partners and like
to 	rush 	through 	an 	assignment. 	On 	Wechsler
Intelligence Scale for Children – V, the claimant had
average full-scale intelligence quotient with average
fluid 	reasoning 	and 	low 	average 	verbal
comprehension 	(Exhibit 	7F-8). 	On 	the 	Wechsler
Individual Achievement Test – IV, the claimant had
average 	word 	reading, 	pseudo-word 	decoding,
reading comprehension, reading, and math fluency
in addition to average subtraction (Exhibit 7F-10,
11). 	However, 	he 	had 	low 	scores 	in 	sentence
composition 	and 	essay 	composition 	and 	below-
average 	scores 	in 	numerical 	operations, 	math
problem solving, math fluency – multiplication, and
mathematics. 	The 	claimant’s 	teachers 	rated 	his
behavior 	as 	average 	regarding 	externalizing
problems, 	aggression, 	hyperactivity, 	and
somatization. He was at risk for attention problems
and study skills. However, he was also rated as
average for learning problems, atypical behavior
problems, withdrawal, adaptive skills, adaptability,
social 	skills, 	leadership, 	and 	functional
communication (Exhibit 7F-13, 14).
On April 3, 2024, the claimant reported that he was
not 	doing 	good 	at 	school 	because 	he 	was 	not
completing his schoolwork due to poor effort (Exhibit
6F-62). 	He 	reported 	that 	his 	ADHD 	medication
worked well in the morning but in the afternoon, he
could not concentrate or focus. He had no behavioral
concerns, but he was not sleeping well until he
increased his trazadone dose to 100 mg instead of 50
mg. The claimant’s mother reported that guanfacine
helped with the claimant’s hyperactivity and he had
no concerns with mood/anxiety. His behaviors had
not been too bad lately and he had been in a better
mood with no new behavioral problems and no new
Case: 5:25-cv-01244-CEF Doc #: 12 Filed: 02/09/26 10 of 22. PageID #: <pageID>

11
aggressive behaviors. Additionally, he was sleeping
well and was weaning off of Topamax successfully.
It was further noted that his mother, his mother’s
boyfriend, and his two sisters lived at his mom’s
house a few blocks away, but he preferred to stay
with his grandmother most of the time. On August
22, 2023, the claimant was behaviorally doing really
good and he had started school (Exhibit 6F-55). He
still had issues with sleep, but he had normal energy
during he day and he did not take naps. There was
some 	concern 	for inattention 	but 	the 	claimant’s
mother 	wanted 	to 	wait 	and 	see 	before 	making
medication adjustments (Exhibit 6F-57).
Tr. 20–25.
The ALJ’s Decision
The ALJ made the following findings of fact and conclusions of law:
1. 	The claimant was born on November 23, 2009.
Therefore, he was an adolescent on January 5,
2023, the date the application was filed, and is
currently an adolescent (20 CFR 416.926a(g)(2)).
2. 	The 	claimant 	has 	not 	engaged 	in 	substantial
gainful 	activity 	since 	January 	5, 	2023, 	the
application date (20 CFR 416.924(b) and 416.971
et seq.).
3. 	The 	claimant 	has 	the 	following 	severe
impairments: 	Attention 	Deficit/Hyperactivity
Disorder 	(ADHD), 	bipolar 	disorder, 	anxiety,
sensory processing disorder, Oppositional Defiant
Disorder (ODD), and autism spectrum disorder (20
CFR 416.924(c)).
4. 	The claimant does not have an impairment or
combination 	of 	impairments 	that 	meets 	or
medically equals the severity of one of the listed
impairments in 20 CFR Part 404, Subpart P,
Appendix 	1 	(20 	CFR 	416.924, 	416.925 	and
416.926).
Case: 5:25-cv-01244-CEF Doc #: 12 Filed: 02/09/26 11 of 22. PageID #: <pageID>

12
5. 	The claimant does not have an impairment or
combination 	of 	impairments 	that 	functionally
equals 	the 	severity 	of 	the 	listings 	(20 	CFR
416.924(d) and 416.926a).
6. 	I find that the claimant has not been disabled, as
defined in the Social Security Act, since January
5, 2023, the date the application was filed (20 CFR
416.924(a)).
Tr. 18–27.
Standard for Disability
A claimant is entitled to receive Supplemental Security Income benefits
if the claimant establishes the existence of a disability. 42 U.S.C. § 1382(a).
“Disability” in the case of a claimant under age 18 is defined as “a medically
determinable physical or mental impairment, which results in marked and
severe functional limitations, and which can be expected to result in death or
which has lasted or can be expected to last for a continuous period of not less
than 12 months.” 42 U.S.C. § 1382c(a)(3)(C)(i).
An ALJ is required to follow a three-step sequential analysis to make a
disability determination for a child claimant:
1. 	Is the claimant engaged in any substantial
gainful activity? If so, the claimant is not disabled.
2. 	Does 	the 	claimant 	have 	a 	medically
determinable impairment that is “severe”? If not, the
claimant is not disabled.
3. 	Does the claimant’s impairment meet or equal
one of the listed impairments and meet the duration
requirement? If so, the claimant is disabled. If not,
the claimant is not disabled.
20 C.F.R. § 416.924(a)–(d).
Case: 5:25-cv-01244-CEF Doc #: 12 Filed: 02/09/26 12 of 22. PageID #: <pageID>

13
To 	determine 	under 	step 	three 	whether 	a 	claimant’s 	impairment
functionally equals a listing, the ALJ considers six domains of functioning: (1)
“[a]cquiring and using information”; (2) “[a]ttending and completing tasks”; (3)
“[i]nteracting and relating with others”; (4) “[m]oving about and manipulating
objects”; (5) “[c]aring for yourself”; and (6) “[h]ealth and physical well-being.”
20 C.F.R. § 416.926a(b)(1)(i)–(vi); see Smoot v. Comm’r of Soc. Sec., No. 5:22-
cv-1235, 2023 WL 1413097, at *12 (N.D. Ohio Jan. 31, 2023); see also M.G. v.
Comm’r of Soc. Sec., 861 F. Supp. 2d 846, 855 (E.D. Mich. 2012) (citing 20
C.F.R. § 416.926a). To establish a functional impairment equal to a listing, the
claimant must show an “extreme” limitation in one domain or a “marked”
impairment in more than one domain. 20 C.F.R. § 416.926a(d). As in any Social
Security disability case, the claimant has the burden of proof. 20 C.F.R. §
416.912(a); see Woodall v. Colvin, No. 5:12-cv-1818, 2013 WL 4710516, at *10
(N.D. Ohio Aug. 29, 2013); Tate ex rel. Tate v. Comm’r of Soc. Sec., 368 F. Supp.
2d 661, 663 (E.D. Mich. 2005).
Standard of Review
A reviewing court must affirm the Commissioner’s conclusions unless it
determines “that the ALJ has failed to apply the correct legal standards or has
made findings of fact unsupported by substantial evidence in the record.”
Jordan, 548 F.3d at 422. “‘[S]ubstantial evidence’ is a ‘term of art’” under which
“a court … asks whether” the “existing administrative record … contains
‘sufficien[t] evidence’ to support the agency’s factual determinations.” Biestek
Case: 5:25-cv-01244-CEF Doc #: 12 Filed: 02/09/26 13 of 22. PageID #: <pageID>

14
v. Berryhill, 587 U.S. 97, 102 (2019) (citations omitted). The substantial
evidence standard “is not high.” Id. Substantial evidence “is ‘more than a mere
scintilla’” but it “means only[] ‘such relevant evidence as a reasonable mind
might accept as adequate to support a conclusion.’” Id. at 103 (citations
omitted). The Commissioner’s “findings … as to any fact if supported by
substantial evidence [are] conclusive.” 42 U.S.C. § 405(g); Biestek, 587 U.S. at
99.
A court may “not try the case de novo, resolve conflicts in evidence, or
decide questions of credibility.” Bass v. McMahon, 499 F.3d 506, 509 (6th Cir.
2007). Even if substantial evidence or a preponderance of the evidence
supports 	a 	claimant’s 	position, 	a 	reviewing 	court 	cannot 	overturn 	the
Commissioner’s decision “so long as substantial evidence also supports the
conclusion reached by the ALJ.” Jones v. Comm’r of Soc. Sec., 336 F.3d 469,
477 (6th Cir. 2003). This is so because there is a “zone of choice within which”
the Commissioner can act, without fear of judicial “interference.” Lindsley v.
Comm’r of Soc. Sec., 560 F.3d 601, 605 (6th Cir. 2009) (quoting Felisky v.
Bowen, 35 F.3d 1027, 1035 (6th Cir. 1994)).
Discussion
Hurst 	argues 	that 	the 	ALJ’s 	failed 	to 	adequately 	explain 	his
consideration 	of 	an 	opinion 	provided 	by 	the 	consultative 	examiner, 	Dr.
Johnson-Brown. See Doc. 8, at 1.
Case: 5:25-cv-01244-CEF Doc #: 12 Filed: 02/09/26 14 of 22. PageID #: <pageID>

15
The Commissioner is required to evaluate the persuasiveness of all
medical 	opinions 	using 	the 	following 	factors: 	supportability; 	consistency;
treatment relationship, including the length, frequency, purpose, and extent;
specialization; and other factors. 20 C.F.R. §§ 416.920c(a), 416.920c(c)(1)–(5).
Supportability and consistency are the most important factors. 20 C.F.R. §
416.920c(a). Supportability means that “[t]he more relevant the objective
medical evidence and supporting explanations presented by a medical source
are to support his or her medical opinion[] … the more persuasive the medical
opinions … will be.” 20 C.F.R. § 416.920c(c)(1). Consistency means “[t]he more
consistent a medical opinion[] … is with the evidence from other medical
sources and nonmedical sources in the claim, the more persuasive the medical
opinion[] … will be.” 20 C.F.R. § 416.920c(c)(2). The Commissioner must
explain the supportability and consistency factors when discussing a medical
opinion. 20 C.F.R. § 416.920c(b)(2). “[A]n ALJ need not,” however, “specifically
use the terms ‘supportability’ or ‘consistency’ in his analysis.” Cormany v.
Kijakazi, No. 5:21-cv-933, 2022 WL 4115232, at *3 (N.D. Ohio Sept. 9, 2022)
(citing cases). The Commissioner is not required to discuss the remaining
factors. Id. “A reviewing court evaluates whether the ALJ properly considered
the factors as set forth in the regulations to determine the persuasiveness of a
medical opinion.” Toennies v. Comm’r of Soc. Sec., 2020 WL 2841379, at *14
(N.D. Ohio June 1, 2020) (internal quotation marks and citation omitted).
Case: 5:25-cv-01244-CEF Doc #: 12 Filed: 02/09/26 15 of 22. PageID #: <pageID>

16
Although an ALJ must discuss the supportability and consistency
factors, 20 C.F.R. § 416.920c(a), the ALJ need not use the magic words
supportability 	and 	consistency. 	See 	Cormany, 	2022 	WL 	4115232, 	at 	*3
(collecting cases). Here, Hurst provides little discussion with regard to whether
the ALJ discussed the substance of supportability and consistency. Instead,
Hurst generally asserts that the “ALJ did not provide any reasoning for how
Dr. Johnson Brown’s opinion was not supported by her own examination” and
that the “ALJ was required to evaluate how [Dr. Johnson-Brown’s findings]
supported 	Dr. 	Johnson-Brown’s 	exam, 	but 	he 	included 	no 	discussion
whatsoever of supportability in his decision.” Doc. 8, at 11–12. The ALJ’s
decision belies this assertion
The ALJ began his discussion of Dr. Johnson-Brown’s opinion by
observing that she:
noted 	that 	the 	claimant 	had 	poor 	hygiene 	and
grooming and his motor activity was observed to be
greater than normal limits. He was unable to sit
quietly 	throughout 	the 	interview 	and 	he 	was
banging on doors and walls when his mother was
speaking 	with 	her. 	He 	was 	unable 	to state 	his
current address or his mother’s cell phone number
and he did not know the correct date. His ability to
concentrate appeared somewhat impaired, but his
immediate 	recall 	appeared 	intact. 	His 	recent
memory appeared intact and his remote memory
appeared significantly impaired. He attempted to be
pleasant and cooperative, but at times was angry
and 	irritable 	and 	his 	mood 	appeared 	somewhat
depressed. 	His 	affect 	was 	flat 	and 	somewhat
restricted, and he made normal eye contact. His
Case: 5:25-cv-01244-CEF Doc #: 12 Filed: 02/09/26 16 of 22. PageID #: <pageID>

17
insight appeared fair to marginal and his judgment
appeared fair. Dr. Johnson-Brown found that the
claimant 	had difficulty 	academically 	keeping 	up
with 	same 	age 	peers, 	he 	had 	difficulty 	paying
attention 	and 	concentrating, 	he 	had 	difficulty
interacting 	with 	others, 	and 	had 	difficulty
completing 	his 	personal 	care. 	She 	assessed 	the
claimant with bipolar I disorder, autism spectrum
disorder, 	and 	attention 	deficit/hyperactivity
disorder.
Tr. 23–24.
The ALJ then compared Dr. Johnson-Brown’s observations to other
evidence. 	See 	id. 	at 	24. 	First, 	Dr. 	Johnson-Brown’s 	observations 	were
inconsistent with Dr. Bromberg’s observation that G.J.D.A. “was overall doing
well,” in that “he did pretty good in school and passed all of his classes with Cs
and Bs, and his ADHD symptoms were well-controlled.” Id. at 24. The ALJ also
contrasted 	Dr. 	Johnson-Brown’s 	observations 	with 	academic 	evidence,
including teacher reports that G.J.D.A. “was doing well and completing
assignments on time, … followed instructions within the classroom, but … had
difficulty with showing his work in math and some difficulty in writing.” Id.
And although G.J.D.A. sometimes became “distracted when working with
partners and like[d] to rush through an assignment[,]” his teachers “rated his
behavior 	as 	average 	regarding 	externalizing 	problems, 	aggression,
hyperactivity, and somatization.” Id. And although G.J.D.A. was thought to be
“at risk for attention problems and study skills,” his teachers “rated” him “as
average 	for 	learning 	problems, 	atypical 	behavior 	problems, 	withdrawal,
Case: 5:25-cv-01244-CEF Doc #: 12 Filed: 02/09/26 17 of 22. PageID #: <pageID>

18
adaptive 	skills, 	adaptability, 	social 	skills, 	leadership, 	and 	functional
communication.” Id.
Finally, the ALJ noted that Hurst had reported positive information,
including that certain medication “helped with [G.J.D.A.’s] hyperactivity and
[that] he had no concerns with mood [or] anxiety. Id. Further, “[h]is behaviors
had [recently] not been too bad[,] he had been in a better mood with no new
behavioral problems and no new aggressive behaviors,” and “he was sleeping
well and was weaning off of Topamax successfully.” Id.
Moving on, the ALJ observed that during:
a consultative mental status examination [i]n May
2023, [with Dr. Johnson-Brown]2 the claimant and
his 	mother 	reported 	that 	the 	claimant 	had
aggressive and assaultive behavior, etc. However,
treatment notes from February 2023, indicate the
claimant was overall doing well; school was going
good and he was no longer failing classes (Exhibit
6F-46). He was not being disruptive, but he was
easily distracted when other students are being
disruptive, and he had no new behavioral problems,
and there were no safety concerns reported. It was
noted that he stayed with his grandmother most of
the time, which was not consistent with the mother’s
testimony 	that 	his 	sister 	had 	to 	go 	to 	her
grandparent’s 	home 	for 	safety. 	Additionally,
treatment 	notes 	immediately 	following 	the
consultative mental status examination indicated
again that the claimant was overall doing well, doing
good in school, passing all his classes, and his ADHD
symptoms were well-controlled. The reports at the
consultative mental status examination were far
2 	See Tr. 422–29.
Case: 5:25-cv-01244-CEF Doc #: 12 Filed: 02/09/26 18 of 22. PageID #: <pageID>

19
different 	from 	the 	treatment 	notes 	and 	this
inconsistency 	does 	not 	support 	the 	claimant’s
allegations of debilitating mental health symptoms.
Treatment 	notes 	show 	one 	episode 	where 	the
claimant got angry and broke a TV. It also indicated
this was not normal behavior for him and this was
an isolated incident. He was generally noted not to
have aggressive behavior. Medication management
notes from the claimant’s psychiatrist, did not show
any 	complaints 	of 	violence 	toward 	siblings.
Additionally, 	in 	April 	2024, 	the 	claimant’s
psychiatrist noted that the claimant had no recent
behavioral problems and his medication therapy
throughout 	the 	years 	had 	controlled 	his
aggressive/violent behaviors with no current safety
concerns (Exhibit 8F). The subjective reports from
the claimant’s mother to Dr. Johnson – Brown, were
far different than subjective reports of the claimant’s
behavior and activities to his treating psychiatrist.
Tr. 25.
Given the above, it is apparent that although the ALJ did not use the
magic 	words 	supportability 	or 	consistency, 	he 	complied 	with 	applicable
regulations. The ALJ compared Dr. Johnson-Brown’s opinion with medical and
other evidence found elsewhere in the record, i.e. consistency, and his decision
shows that he considered how the subjective reports within Dr. Johnson-
Brown’s opinion did or did not support her opinion, i.e. supportability. See Tr.
25. For instance, the ALJ showed how he considered the consistency of Dr.
Johnson-Brown’s 	opinion 	by 	stating: 	“At 	a 	consultative 	mental 	status
examination on May 2023, the claimant and his mother reported that the
claimant had aggressive and assaultive behavior, etc. However, treatment
Case: 5:25-cv-01244-CEF Doc #: 12 Filed: 02/09/26 19 of 22. PageID #: <pageID>

20
notes from February 2023, indicate the claimant was overall doing well; school
was going good and he was no longer failing classes (Exhibit 6F-46).” Tr. 25
(emphasis added). By comparing the consultative examination in May 2023
with treatment notes from another provider in February 2023, as evidenced by
use of the word however, the ALJ showed that he considered the consistency
factor with regard to Dr. Johnson-Brown’s opinion. Id.; see also Tr. 23–24.
Additionally, the ALJ showed that he considered the supportability of
Dr. Johnson-Brown’s opinion by explaining that the “subjective reports from
the 	claimant’s 	mother to 	Dr. Johnson-Brown” 	and “[t]he 	reports 	at 	the
consultative mental status examination,” both of which are solely detailed
within the consultative examiner’s report, did “not support the claimant’s
allegations of debilitating mental health symptoms.” Tr. 25. In sum, a review
of the ALJ’s evaluation, illustrates that he considered the supportability and
consistency of Dr. Johnson-Brown’s opinion as required––albeit without using
the magic words. See Tr. 25; 20 C.F.R. § 416.920c(b)(2).
As Hurst identifies, the ALJ discussed Dr. Johnson-Brown’s opinion in
conjunction with the summary of medical evidence and then proceeded to
explain how he “considered the medical opinions in accordance with the
applicable regulations. See Doc. 8, at 9. For this reason Hurst appears to—in
addition to her claim that the ALJ failed to discuss supportability and
consistency—challenge the structure of the ALJ’s decision. But the ALJ wasn't
required to discuss the opinion evidence in a particular order or organize his
Case: 5:25-cv-01244-CEF Doc #: 12 Filed: 02/09/26 20 of 22. PageID #: <pageID>

21
discussion of the opinions so that he discussed all of them in one section––
although that would have been helpful.
Because the ALJ’s decision must be viewed as a whole, his discussion
discounting a medical opinion in conjunction with discussion of evidence found
elsewhere in the ALJ’s decision satisfies the articulation requirement for
opinion evidence. See, e.g., Chicora v. Comm’r of Soc. Sec., 852 F. App’x 968,
970 (6th Cir. 2021) (the ALJ’s brief explanation discounting a medical opinion,
in conjunction with the ALJ’s discussion of the doctor’s treatment notes and
exam findings elsewhere in the decision, satisfied the articulation requirement
for opinion evidence); Crum v. Comm’r of Soc. Sec., 660 F. App’x 449, 457 (6th
Cir. 2016) (same)3; Kraig v. Kijakazi, No. 1:21-cv-1253, 2022 WL 4232692, at
*9 (N.D. Ohio Sept. 14, 2022) (ALJ’s evaluation of opinion evidence read “in
the context of the decision as a whole” contained sufficient articulation for
discounting the opinion) (collecting cases). When read as a whole, 	the ALJ
discussed the supportability and consistency of Dr. Johnson-Brown’s opinion.
Hurst’s sole argument, thus, does not provide a basis for remand.
3 	In 	Chicora 	and 	Crum, 	the 	former 	regulations 	governing 	treating
physician opinions applied to the claimant’s disability application. Chicora,
852 F. App’x at 969–70; Crum, 660 F. App’x at 456. Those former regulations
were more demanding than the current ones. See, e.g., Kraig v. Kijakazi, No.
1:21-cv-1253, 2022 WL 4232692, at *8 (N.D. Ohio Sept. 14, 2022). So there is
nothing to suggest that the approach endorsed under the former regulations—
to read the ALJ’s decision as whole—wouldn’t apply under the current
regulations. See id.
Case: 5:25-cv-01244-CEF Doc #: 12 Filed: 02/09/26 21 of 22. PageID #: <pageID>

22
Conclusion
For the reasons stated, I recommend that the Commissioner’s decision
be affirmed.
Dated: February 9, 2026 	/s/ James E. Grimes Jr.
James E. Grimes Jr.
United States Magistrate Judge
OBJECTIONS
Any objections to this Report and Recommendation must be filed with
the Clerk of Court within 14 days after the party objecting has been served
with a copy of this Report and Recommendation. 28 U.S.C. § 636(b)(1). Failure
to file objections within the specified time may forfeit the right to appeal the
District Court’s order. See Berkshire v. Beauvais, 928 F.3d 520, 530–31 (6th
Cir. 2019).
Case: 5:25-cv-01244-CEF Doc #: 12 Filed: 02/09/26 22 of 22. PageID #: <pageID>