Rebecca Hernandez v. Comm of Social Security

Filing

OPINION filed : AFFIRMED the district court's judgment, decision not for publication. Eugene E. Siler , Jr., Circuit Judge; Deborah L. Cook, Circuit Judge and Bernice Bouie Donald, Circuit Judge (AUTHORING).

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NOT RECOMMENDED FOR FULL-TEXT PUBLICATION
File Name: 16a0154n.06
Case No. 15-1875
UNITED STATES COURT OF APPEALS
FOR THE SIXTH CIRCUIT

REBECCA HERNANDEZ,

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Plaintiff-Appellant,
v.
COMMISSIONER OF SOCIAL SECURITY,
Defendant-Appellee.

FILED
Mar 17, 2016
DEBORAH S. HUNT, Clerk

ON APPEAL FROM THE UNITED
STATES DISTRICT COURT FOR
THE WESTERN DISTRICT OF
MICHIGAN

OPINION

BEFORE: SILER, COOK, and DONALD, Circuit Judges.
BERNICE BOUIE DONALD, Circuit Judge. The Commissioner of Social Security
denied Rebecca Hernandez’s (“Hernandez”) application for Supplemental Security Income
benefits. Pursuant to 42 U.S.C. § 405(g), Hernandez sought judicial review of that decision in
the district court, which affirmed the denial of benefits. She now appeals, asserting that the
administrative law judge committed a number of errors in reviewing her application. For the
following reasons, we AFFIRM the district court’s judgment.
I.
Hernandez, now twenty-seven years old, has a family history of mental illness. At a very
young age, she was diagnosed with major depression and anxiety.

She took a variety of

prescription medications in connection with these disorders throughout her childhood and

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teenage years. Hernandez eventually dropped out of high school but was able to obtain a GED.
Still, she has never held a job or looked for employment.
A.
The record details Hernandez’s long journey in managing her major depression and
bipolar II disorder. On March 27, 2007, when she was eighteen years old, Hernandez was
hospitalized for depression and suicidal thoughts. She denied having taken any medication for
her disorders in the past two years. The attending physician referred her to the Adult Mental
Health unit of the hospital, where she stayed until her father discharged her on March 29 against
medical advice. Her medical chart indicates that she seemed to stabilize psychologically once
the hospital had begun administering medication.
After her discharge, Hernandez sought treatment from Mesa Counseling Services and Dr.
Denise Dittemore through 2011. During their sessions, Dr. Dittemore generally noted that
Hernandez was “good” about taking her medications. In 2012, Hernandez saw Dr. Marissa
Mejia, who also worked out of Mesa Counseling Services. Dr. Mejia’s treatment notes indicate
that Hernandez was “fair” about taking her medications.

From 2007 to 2012, Hernandez

periodically received Global Assessment of Functioning scores, which ranged from 25 to 55.1
B.
On September 9, 2011, Hernandez filed an application for Supplemental Security Income
(“SSI”) benefits. She filed for reconsideration after initially being denied. When her application
1

A Global Assessment of Functioning (GAF) score of 55 indicates “moderate symptoms and
moderate difficulty in social, occupational or school functioning.” DeBoard v. Comm’r of Soc.
Sec., 211 F. App’x 411, 415 (6th Cir. 2006). It is a subjective evaluation of a claimant’s overall
functional ability. Id. We have previously noted that “the Commissioner has declined to
endorse the [GAF] score for use in the Social Security and Supplemental Security Income
disability programs, and has indicated that [GAF] scores have no direct correlation to the
severity requirements of the mental disorders listings.” Id. (quoting Wind v. Barnhart, 133 F.
App’x 684, 692 n.5 (11th Cir. 2005) (internal quotation marks and alternations omitted).
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was again denied, she submitted a written request for a hearing. Hernandez appeared before an
administrative law judge (“ALJ”) on October 26, 2012. There, she testified that when she turned
twenty-one years old, she was diagnosed with bipolar II disorder along with her major
depression and anxiety. She was prescribed several medications to deal with her disorders.
Those medications caused her to lack concentration, have occasional short term memory loss,
and be drowsy. She explained that she spends a lot of time at home on the computer; that she
rarely contributes to managing the household; that she will only go grocery shopping if she is
accompanied by another individual; that she does not drive; and that she can sit, stand, and walk
normally. Hernandez also testified that she does not work because her bipolar II disorder causes
her to have depressive states and lack motivation. She elaborated that she has hypomania, which
causes her to occasionally have energy, but she still regularly fails to complete projects or stay
focused.
Dr. Dittemore completed a medical source statement (“MSS”), dated September 26,
2011, in support of Hernandez’s application. The MSS is a form that asks physicians to check
various boxes that describe different types of mental limitations. Dr. Dittemore noted that
Hernandez was not limited with respect to five categories.2

However, she indicated that

Hernandez’s limitations were moderate in three categories,3 marked in nine categories,4 and

2

Dr. Dittemore marked that Hernandez had no limitation with respect to her ability to remember
locations and work-like procedures; ability to understand and remember very short and simple
instructions; ability to carry out very short and simple instructions; ability to make simple workrelated decisions; and ability to be aware of normal hazards and take appropriate precautions.
3

A moderate degree of limitation is one where “[t]he individual will have intermittent difficulty
performing in [the] area.” R. 9-7, PageID #273. Dr. Dittemore indicated that Hernandez had a
moderate degree of mental limitation with respect to her ability to sustain an ordinary routine
without special supervision; ability to work in coordination with or in proximity to others
without being distracted by them; and ability to maintain socially appropriate behavior and to
adhere to basic standards of neatness and cleanliness.
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extreme in at least five categories.5 She also indicated that Hernandez would likely have four
absences from work per month but that she could also manage any benefits in her own best
interest. Dr. Dittemore did not elaborate in the sections below that requested “support” for a
given assessment. R. 9-7, PageID #273-75.
In addition to the MSS, Hernandez’s SSI application included several supporting
documents.

She submitted her treatment notes from Dr. Dittemore, Dr. Mejia, and her

2007 hospitalization. Hernandez also completed an Adult Function Report, where she stated that
she can prepare simple meals, do laundry, wash dishes, and clean her home. Her answers largely
track her testimony at the hearing. The record also includes two medical opinions from state
agency medical and psychological consultants. These doctors concluded, both originally and
upon reconsideration, that Hernandez was not disabled. They explained that she could perform
non-public, unskilled work.

4

A marked degree of limitation is one that “is [a] serious limitation,” where the “individual
cannot generally perform satisfactorily in [that] area.” R. 9-7, PageID #273. Dr. Dittemore
checked “marked” with respect to Hernandez’s ability to understand and remember detailed
instructions; ability to carry out detailed instructions; the ability to perform activities within a
schedule, maintain regular attendance, and be punctual within customary tolerances; ability to
perform at a consistent pace with a standard number and length of rest periods; ability to ask
simple questions or request assistance; ability to accept instructions and respond appropriately to
criticism from supervisors; ability to get along with coworkers or peers without distracting them
or exhibiting behavioral extremes; the ability to respond appropriately to changes in the work
setting; and the ability to set realistic goals or make plans independently of others.
5

An extreme limitation is described as “major,” where an individual has “no useful ability to
function in this area.” R. 9-7, PageID #273. According to Dr. Dittemore’s MSS, Hernandez had
an extreme limitation in her ability to complete a normal workday without interruptions from
psychologically based symptoms; ability to complete a normal workweek without interruptions
from psychologically based symptoms; ability to interact appropriately with the general public;
and ability to travel in unfamiliar places or use public transportation. The form also seems to
indicate that Dr. Dittemore believes Hernandez has an extreme limitation when in reference to
her ability to maintain attention and concentration for extended periods, but it is difficult to
confirm due to poor photocopying.
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A vocational expert also testified at the ALJ hearing. She explained that a significant
number of jobs existed in Hernandez’s community and throughout the country that were
unskilled and had occasional social interaction. Conversely, she testified that neither the national
nor the local economy contained jobs that had only occasional contact with a supervisor; that had
no social interaction; that were limited to repetitive tasks; and that would allow an employee to
be off-task at least twenty percent of the time.
The ALJ determined that Hernandez was not disabled. He concluded that Hernandez was
not engaged in substantial gainful activity and that her impairments (bipolar disorder and
anxiety) were severe. However, the ALJ found that Hernandez “does not have an impairment or
combination of impairments that meets or medically equals the severity of one of the listed
impairments in” 20 C.F.R., Subpart (P), Appendix 1. R. 9-2, PageID #86. This was because he
determined that Hernandez had no restrictions in her daily living activities, moderate difficulties
with social functioning, moderate difficulties with concentration, and no episodes of
decompensation. Thus, the ALJ concluded that Hernandez had a “residual functional capacity
[“RFC”] to perform a full range of work at all exertional levels but with the following
nonexertional limitations: simple, repetitive tasks; and only occasional interaction with the
public.” Id. at 87.
In connection with his RFC decision, the ALJ found Hernandez’s testimony lacking
credibility insofar as she described “the intensity, persistence and limiting effects of her
symptoms.” Id. at 88. He also determined that the Adult Third Party Function Report filled out
by Hernandez’s boyfriend, Isaac James Drew (“Drew”), lacked credibility due to Drew’s
inherent bias interest and because Drew’s assertions conflicted with other objective evidence in
the record. The ALJ also declined to give controlling weight to Dr. Dittemore’s MSS, as it “was

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not supported by the objective medical evidence.” Id. at 90. Finally, the ALJ also gave little
weight to the state agency’s determinations, as they “were not supported by the record.” Id.
Because Hernandez had never worked before, the ALJ consulted the vocational expert’s
findings. Based on her assertion that unskilled, occasionally social jobs existed in the economy,
the ALJ determined that Hernandez was not disabled. On June 17, 2014, the Appeals Council
denied Hernandez’s request for review. Pursuant to 42 U.S.C. § 405(g), Hernandez filed suit in
the district court, seeking judicial review of the ALJ’s decision. The district court affirmed the
ALJ’s denial of benefits on June 4, 2015. Hernandez timely appeals.
II.
We apply a de novo standard of review to cases involving applications for SSI benefits.
Shilo v. Comm’r of Soc. Sec., 600 F. App’x 956, 957 (6th Cir. 2015). The burden is on the
plaintiff to prove that she is disabled within the meaning of the regulations, and we are limited to
reviewing the record before the ALJ. Ealy v. Comm’r of Soc. Sec., 594 F.3d 504, 512 (6th Cir.
2010); Friend v. Comm’r of Soc. Sec., 375 F. App’x 543, 550 (6th Cir. 2010). That being said,
we may only consider “whether the Commissioner’s decision ‘is supported by substantial
evidence and was made pursuant to proper legal standards.’” Ealy, 594 F.3d at 512 (quoting
Rogers v. Comm’r of Soc. Sec., 486 F.3d 234, 241 (6th Cir. 2007)). “The substantial-evidence
standard is met if a ‘reasonable mind might accept the relevant evidence as adequate to support a
conclusion.’” Blakley v. Comm’r of Soc. Sec., 581 F.3d 399, 406 (6th Cir. 2009) (quoting
Warner v. Comm’r of Soc. Sec., 375 F.3d 387, 390 (6th Cir. 2004)). We may affirm even if
evidence in the record supports the opposite conclusion. See Key v. Callahan, 109 F.3d 270, 273
(6th Cir. 1997).

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Hernandez first asserts that the ALJ erred in declining to give controlling weight to Dr.
Dittemore’s MSS under the treating physician rule. She further contends that the ALJ erred in
declining to give sufficient weight to the two state agency medical and psychological
consultants. Second, she claims that substantial evidence does not exist in the record to support
the ALJ’s finding that she is not disabled because he declined to consider any of the medical
opinions in the record.

Lastly, she challenges the ALJ’s adverse credibility determination

against her and her boyfriend, Drew. We review each issue in turn.
A.
The treating physician rule requires agencies making a disability determination to
generally
give more weight to opinions from treating sources, since these sources are likely
to be the medical professionals most able to provide a detailed, longitudinal
picture of [] medical impairment(s) and may bring a unique perspective to the
medical evidence that cannot be obtained from the objective medical findings
alone or from reports of individual examinations, such as consultative
examinations or brief hospitalizations.
20 C.F.R. § 404.1527(c)(2). Treating physicians’ opinions are given “controlling weight” when
their opinions are “well-supported by medically acceptable clinical and laboratory diagnostic
techniques and [are] not inconsistent with the other substantial evidence in [the] case record.”
Id. If an ALJ declines to give controlling weight to a treating physician, he must “always give
good reasons.” Id. In other words, “it is not enough to dismiss a treating physician’s opinion as
‘incompatible’ with other evidence of record; there must be some effort to identify the specific
discrepancies and to explain why it is the treating physician’s conclusion that gets the short end
of the stick.” Friend, 375 F. App’x at 552. An ALJ must also determine what weight—if not
controlling—to give the treating physician’s opinion, by “apply[ing] certain factors—namely, the
length of the treatment relationship and the frequency of examination, the nature and extent of
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the treatment relationship, supportability of the opinion, consistency of the opinion with the
record as a whole, and the specialization of the treating source.” Wilson v. Comm’r of Soc. Sec.,
378 F.3d 541, 544 (6th Cir. 2004).
If an ALJ fails to give good reasons for declining to give a treating physician’s opinion
controlling weight, “[w]e will reverse and remand a denial of benefits, even though ‘substantial
evidence otherwise supports the decision of the Commissioner.’” Friend, 375 F. App’x at 551
(quoting Wilson, 378 F.3d at 543-46). “[A]n ALJ cannot simply invoke the criteria set forth in
the regulations if doing so would not be ‘sufficiently specific’ to meet the goals of the ‘good
reason’ rule.” Id. At the same time, we may conclude that an insufficient discussion may be
harmless error if
(1) a treating source’s opinion is so patently deficient that the Commissioner
could not possibly credit it; (2) if the Commissioner adopts the opinion of the
treating source or makes findings consistent with the opinion; or (3) where the
Commissioner has met the goal of § 1527(d)(2)—the provision of the procedural
safeguard of reasons—even though she has not complied with the terms of the
regulation.
Id. (internal quotation marks omitted) (quoting Wilson, 378 F.3d at 547). If we may clearly infer
the reasons the ALJ declined to give controlling weight to a treating physician’s opinion, “strict
compliance with the rule may sometimes be excused.” Id.
Here, the ALJ rejected the MSS, determining that it was not supported by the objective
medical evidence in the record, “as discussed above.” R. 9-2, PageID #90. The previously
mentioned objective medical evidence includes the 2007 hospitalization for suicidal thoughts; a
treatment note from May 16, 2011, that indicates that Hernandez felt her medication was helping
her; and treatment notes from May 21, 2012 and July 25, 2012 that indicate that Hernandez
either was not routinely taking her medications or was not taking the right dosages of her
medications.

The ALJ also specifically mentioned Hernandez’s ability to handle financial
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matters, ability to prepare simple meals, and desire to move to Michigan to live with Drew.
Lastly, the ALJ also rejected the MSS because it stated conclusions reserved for the
Commissioner.
Although the ALJ did not specifically identify the previously discussed objective medical
evidence, it is clear which evidence he was referring to and thus strict compliance with the
regulations is not necessary in this instance. See Friend, 375 F. App’x at 551. Still, Hernandez
argues that the objective medical evidence is not inconsistent with Dr. Dittemore’s indicated
limitations on her mental functioning. However, it is nearly impossible to analyze whether that
is true because Dr. Dittemore’s check-box analysis is not accompanied by any explanation. For
example, she does not explain whether these boxes reflect Hernandez’s limitations when she is
taking her medication or if these boxes reflect when she is not taking her medication. We have
previously declined to give significant weight to rudimentary indications that lack an
accompanying explanation. See Keeton v. Comm’r of Soc. Sec., 583 F. App’x 515, 525 (6th Cir.
2014) (quoting SSR 96-2p, at *1, which states that “[a] case cannot be decided in reliance on a
medical opinion without some reasonable support for the opinion”); see also Mason v. Shalala,
994 F.2d 1058, 1065 (3d Cir. 1993) (“Form reports in which a physician’s obligation is only to
check a box or fill in a blank are weak evidence at best.”). Even if the ALJ erred in failing to
give good reasons for not abiding by the treating physician rule, it was harmless error because
the MSS here is “weak evidence at best” and meets our patently deficient standard. See Friend,
375 F. App’x at 551.
Furthermore, this is not a case where the ALJ is substituting his “own interpretation of
medical records for that of a physician who has examined the records.” Brown v. Comm’r of
Soc. Sec., 602 F. App’x 328, 331 (6th Cir. 2015). The ALJ properly discussed objective

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evidence in the record that demonstrates that Hernandez’s symptoms lessen when she is
compliant with her medication, that she frequently has issues taking the right medication at the
right time, and that she can tolerate certain limited social interactions, such as shopping and
interacting with her boyfriend. To the extent that Dr. Dittemore’s check-box analysis conflicts
with such evidence, the ALJ properly discounted the MSS. The conflicting objective evidence
and the absence of any elaboration regarding Hernandez’s purported limitations properly
constitute “good reasons” for rejecting the MSS.
Hernandez also contends that the ALJ wrongfully gave “little weight” to the examining
state agency medical and psychological consultants’ analysis, who indicated that Hernandez
should be limited to non-public, unskilled work. R. 9-3, PageID #141. When evaluating the
weight of a non-treating physician, the regulations require an ALJ to consider “the consultant’s
medical specialty and expertise in [the benefits] rules, the supporting evidence in the case record,
supporting explanations the medical or psychological consultant provides, and any other factors
relevant to the weighing of the opinions.” 20 C.F.R. § 404.1527(e)(2)(ii). Such opinions are
entitled to less deference than controlling treating-physician opinions, but more deference than
non-treating, non-examining opinion sources. See Norris v. Comm’r of Soc. Sec., 461 F. App’x
433, 439 (6th Cir. 2012).
The only difference between the ALJ’s determination and the consultants’ conclusion is
whether Hernandez can handle occasional interaction with the general public or whether she
should be limited to non-public jobs. In the Adult Function Report, to which the ALJ refers,
Hernandez indicated that she can go out alone but that “usually” someone accompanies her. R.
9-6, PageID #239. She also indicated that she shops two to three times per month and that she
goes on family outings once per month.

The ALJ, however, failed to acknowledge that

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Hernandez reported that she felt extremely uncomfortable and that she shakes during each of her
experiences in public. Moreover, she only ventures out alone because she has to in order to
attend her therapy sessions or pick up her medications. He also failed to note that she indicated
that she could not go out in public for more than an hour. Instead, the ALJ explained that the
consultants’ conclusion was not supported by the record, as Hernandez herself admitted that “she
had a boyfriend and could shop in [] stores.” R. 9-2, PageID #90. However, evidence of seldom
shopping and interacting with her boyfriend does not support the conclusion that Hernandez can
“do any of these activities on a sustained basis, which is how the functional limitations of mental
impairments are to be assessed.” Gayheart v. Comm’r of Soc. Sec., 710 F.3d 365, 377 (6th Cir.
2013). The ALJ did not discuss any additional reasons for affording the consultants’ conclusions
“little weight.”
Still, any error was harmless.

While the consultants’ review acknowledged that

Hernandez had been prescribed several medications, they never discuss whether she consistently
takes those medications.

They also never discuss what effect those medications have on

Hernandez and her symptoms. In fact, no doctor opines on whether Hernandez would exhibit the
same mental limitations that she complains of, even if she maintained compliance with her
medication regiment. In this way, like the MSS, the consultants’ findings are of limited value.
Therefore, the ALJ’s finding that they are entitled to “little weight” is harmless error.
B.
Second, Hernandez argues that the ALJ’s RFC decision was not supported by any
medical opinion, as he rejected or gave little weight to the ones in the record. In making this
argument, Hernandez cites to numerous district court cases, suggesting that they stand for the
proposition that an ALJ’s decision cannot be upheld if he rejects all underlying medical opinions.

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See, e.g., Ritchie v. Comm’r of Soc. Sec., No. 1:14-cv-286, 2015 WL 46121, at *6 (S.D. Ohio Jan
2, 2015) (noting that “[c]ases in which an ALJ has independently determined an RFC, while
rejecting or giving ‘little weight’ to virtually all of the medical opinion evidence, may not always
reflect error, but naturally invite closer scrutiny”); Steadman v. Comm’r of Soc. Sec., No. 1:10cv-801, 2011 WL 6415512, at *12 (S.D. Ohio Nov. 14, 2011) (explaining that “[t]he ALJ failed
to articulate the basis for his RFC opinion and to link his RFC determination with specific
evidence in the record”).
Bearing in mind that it is the plaintiff who must prove that she is disabled, the ALJ in this
case did not “fashion an RFC out of whole cloth.” Steadman, 2011 WL 6415512, at *13.
Consistent with the state agency medical consultants’ opinion, he determined that Hernandez
was able to complete simple, repetitive work. The ALJ also pointed to objective evidence in the
record aside from the doctors’ opinions: Hernandez’s own testimony and admissions as well as
hospitalization records and treatment notes. Even though the ALJ’s decision might invite further
scrutiny due to its limited reliance on doctors’ opinions, nothing suggests that the ALJ quilted
together solely subjective determinations in fashioning the RFC.
C.
Lastly, Hernandez challenges the ALJ’s adverse credibility determination regarding her
and her boyfriend, Drew. Credibility is properly evaluated by the ALJ, not the reviewing court.
Rogers, 486 F.3d at 247.

While in theory we will not “disturb” an ALJ’s credibility

determination without a “compelling reason,” Smith v. Halter, 307 F.3d 377, 379 (6th Cir. 2001),
in practice ALJ credibility findings have become essentially “unchallengeable,”

Payne v.

Commissioner of Social Security, 402 F. App’x 109, 113 (6th Cir. 2010). When a credibility
determination regarding a claimant’s subjective complaint is at issue, we affirm if the ALJ’s

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determination is “reasonable and supported by substantial evidence.” Rogers, 486 F.3d at 249.
In other words,
[w]henever a claimant’s complaints regarding symptoms, or their intensity and
persistence, are not supported by objective medical evidence, the ALJ must make
a determination of the credibility of the claimant in connection with his or her
complaints based on a consideration of the entire case record. The entire case
record includes any medical signs and lab findings, the claimant’s own complaints
of symptoms, any information provided by the treating physicians and others, as
well as any other relevant evidence contained in the record. Consistency of the
various pieces of information contained in the record should be scrutinized.
Id. at 247 (internal quotation marks omitted).
The ALJ determined that Hernandez was less than fully credible, as “[i]t appears the
limited range of daily activities is a lifestyle choice and not due to any established impairment.”
R. 9-2, PageID #88. The ALJ stated that Hernandez might be experiencing symptoms as she
describes, but he also explained that the symptoms were potentially due to Hernandez’s failure to
take medication as prescribed.
Substantial evidence in the record supports the ALJ’s credibility determination, and no
compelling reason exists to overturn that decision. Contrary to Hernandez’s assertions, the ALJ
is not simply regurgitating boilerplate language in explaining his reasoning for finding her less
than fully credible. See Cox v. Comm’r of Soc. Sec., 615 F. App’x 254, 260 (6th Cir. 2015)
(explaining that there is a risk that “an ALJ will mistakenly believe it sufficient to explain a
credibility finding” to recite boilerplate language); see also Forrest v. Comm’r of Soc. Sec.,
591 F. App’x 359, 366 (6th Cir. 2014) (declining to find that the ALJ had simply reiterated
boilerplate language where the ALJ had explained his reasons for finding an individual not fully
credible elsewhere in the opinion). Here, the ALJ points to instances in the record where
Hernandez was inconsistent about taking her medication, which she admitted affected her
symptoms. Additionally, Hernandez concedes that she has the ability to handle financial matters,
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perform household chores, maintain her personal hygiene, occasionally shop in public for short
periods of time, maintain focus on a project for up to a day at a time, and prepare simple meals.
The ALJ explained that Hernandez responds well to medication and that any issues she faces in
accomplishing these tasks might be alleviated by proper adherence to her medication regiment.
Nothing in the record contradicts this observation. Accordingly, the ALJ’s determination is
reasonable and reflects the substantial evidence in the record. Hernandez has not demonstrated a
compelling reason to disturb the credibility determination against her.
With respect to Drew’s Adult Third Party Function Report, the ALJ also concluded that
he was less than fully credible. In making that determination, the ALJ noted that he was a
layperson, financially and emotionally biased, and, “[m]ost importantly,” the information he
presented was inconsistent with the objective medical evidence. R. 9-2, PageID #89. To the
extent that Drew’s opinion of Hernandez’s abilities was inconsistent with the ALJ’s RFC
assessment, the ALJ found those statements not credible.
Because the ALJ relied on objective evidence in the record, including Hernandez’s own
assessment of her limitations, there is no compelling reason to overturn the ALJ’s credibility
determination. See Ritchie v. Comm’r of Soc. Sec., 540 F. App’x 508, 511-12 (6th Cir. 2013)
(refusing to disturb a credibility determination when the determination was based on “both the
medical record and plaintiff’s own assessment of his abilities and limitations”); see also Morgan
v. Barnhart, 142 F. App’x 716, 724-25 (4th Cir. 2005) (declining to overturn a credibility
determination when an ALJ concluded that there was inherent familial bias “because the ALJ did
not, in fact, discredit the observations of [the claimant’s] family members solely because of
inherent familial bias”). We therefore decline to do so.

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III.
For the foregoing reasons, we AFFIRM the district court’s judgment.

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