United States District Court, W.D. New York
DECISION AND ORDER 
LAWRENCE J. VILARDO UNITED STATES DISTRICT JUDGE.
March 4, 2016, the plaintiff, Tracey Ann Bell, brought this
action under the Social Security Act (“the Act”).
She seeks review of the decision of the Acting Commissioner
of Social Security (“the Commissioner”) that she
was not disabled within the meaning of the Act. Docket Item
1; Tr. 18-25. On October 26, 2016, this Court referred this
case to United States Magistrate Judge Michael J. Roemer.
Docket Item 7. On September 30, 2016, Bell moved for judgment
on the pleadings, Docket Item 6, and on December 12, 2016,
the Commissioner responded and cross moved for judgment on
the pleadings, Docket Item 9.
October 25, 2017, Judge Roemer issued a Report and
Recommendation (“R&R”) finding that
Bell's motion for judgment on the pleadings should be
denied and that the Commissioner's cross motion for
judgment on the pleadings should be granted. Docket Item 12.
On November 8, 2017, Bell objected to the R&R. Docket
Item 13. The Commissioner did not file a response to
Bell's objection. Oral argument was held on January 3,
2018, and this Court reserved decision. Docket Item 18. For
the reasons stated below, this Court adopts the R&R,
denies Bell's motion, and grants the Commissioner's
August 22, 2012, Bell applied for Social Security Disability
Insurance benefits (“SSDI”). Tr.
127-28. She claimed that she had been disabled
since August 2011 due to chronic immune thrombocytopenic
purpura, chronic iron deficiency, back and sciatic nerve
injury, knee injury, confusion, some memory loss, and uneven
gait. Tr. 139. On November 15, 2012, Bell received notice
that her application was denied because she was not disabled
under the Act. Tr. 79. She requested a hearing before an
administrative law judge (“ALJ”), Tr. 86-87,
which was held on February 6, 2014, Tr. 30. The ALJ then
issued a decision on April 11, 2014, confirming the finding
that Bell was not disabled under the Act. Tr. 29. Bell
appealed the ALJ's decision, but her appeal was denied,
and the decision then became final. Tr. 1. On March 4, 2016,
Bell filed this action, asking this Court to review the
ALJ's decision. Docket Item 1.
RELEVANT MEDICAL EVIDENCE
this Court adopts Judge Roemer's excellent recitation of
the evidence, it provides the following summary to focus on
the medical evidence most relevant to Bell's objections.
Bell was examined by several medical providers, but three are
of particular significance to the claim of mental impairment
at issue here-Gregory Fabiano, Ph.D.; J. Echevarria, M.D.;
and Bela Ajtai, M.D.
October 23, 2012, Dr. Fabiano conducted a psychiatric
evaluation of Bell. Tr. 244. He noted that Bell denied any
symptoms of depression, anxiety, mania, or other thought
disorders, but that she did complain of memory-related
problems. Tr. 245. Dr. Fabiano observed her demeanor,
appearance, thought process, and memory; he found that she
was responsive to questions, that she was cooperative, and
that her memory seemed intact. Tr. 245-46. He concluded that
“the results of the examination do not appear to be
consistent with psychiatric problems that would be
significant enough to interfere” with daily
functioning. Tr. 247.
weeks later, on November 7, 2012, Dr. Echevarria, a state
agency physician, reviewed Bell's medical records and
completed the standard psychiatric review technique form. Tr.
271. Relying on Dr. Fabiano's evaluation, the lack of any
psychiatric hospitalizations, and the absence of any
psychiatric-related treatments, Dr. Echevarria found that
Bell had no medically-determinable impairment. Tr. 283.
in May 2013 at the request of Bell's treating primary
care physician, Tr. 372, Dr. Ajtai conducted a neurological
review. He evaluated Bell's cognitive functioning and
memory loss based on her self-reported symptoms. Id.
At the initial consultation on May 8, Dr. Ajtai noted that
Bell had some delayed-recall difficulties, and he ordered an
MRI to rule out cerebral volume loss, microbleeds, and
lesions. Tr. 374. But after reviewing the MRI, Dr. Ajtai
found that it was a “[n]ormal MRI scan of the
brain.” Tr. 371. Dr. Ajtai did note the
“[p]rominence of the Meckel's cave bilaterally,
” but he also noted that this may simply be an
anatomical variant, Tr. 371, and referred to this finding as
“incidental.” Tr. 376. After Bell's
follow-up visit on June 10, 2013, Dr. Ajtai reported that he
“could not find any obvious progressive cause” of
the memory loss, Tr. 376, and he recommended “regular
brain exercises” and “vitamin
supplementations” for any lingering cognitive
difficulties, Tr. 378. He also recommended a follow-up MRI
with contrast media, Tr. 378, but there is no evidence in the
record that Bell ever had that test done.
THE ALJ'S DECISION
denying Bell's application for SSDI, the ALJ analyzed her
claim under the Social Security Administration's
five-step evaluation process for disability determinations.
See 20 C.F.R. Section 404.1520. The ALJ found that
Bell had the following severe impairments: degenerative disc
disease of the lumbar spine; obesity; chronic immune
thrombocytopenic purpura with low platelet count; and a
history of seizure disorder. Tr. 20. Notably, Bell's
claimed memory loss and cognitive dysfunction were not
included on the list. Id. Because the ALJ found
Bell's severe impairments not to be medically equal to
the impairments in Appendix 1 of the Commissioner's
regulations, the ALJ analyzed Bell's residual functioning
of the RFC, the ALJ considered Bell's subjective mental
symptoms, the various medical opinions, the MRI results, and
Bell's life activities. Tr. 21-24. The ALJ noted that the
neurological testing showed a delayed response but that the
MRI and objective testing were negative. Tr. 24. The ALJ also
found that the psychiatric evaluations did not evidence any
issue with attention, concentration, or memory. Id.
Although the ALJ found that Bell had some severe impairments
as noted ...