In 2015, Rhonda Chicora applied for disability and disability insurance benefits. An Administrative Law Judge denied her application, and the district court affirmed the ALJs decision, granting the Commissioner of Social Securitys motion for summary judgment. Chicora now appeals, arguing that the ALJ failed to adhere to the treating physician rule; that substantial evidence did not support the ALJs determination that Chicoras impairments do not meet the requirements or their medical equivalence of certain listed disabilities in the Social Security Administrations regulations; and that the Commissioner failed to show that Chicora can perform any jobs in the national economy. For the following reasons, we affirm.
I.
Chicora has a GED and specialized training in medical administration. She last worked as a scheduler at a hospital.
Chicora first applied for disability benefits on October 15, 2012, alleging a disability onset date of October 30, 2011. An ALJ denied her application on March 22, 2014. After the Appeals Council denied review of that first decision, Chicora applied for disability insurance benefits again, alleging the same onset date. When her second application was again denied, Chicora requested a hearing before an ALJ. She alleged that she had been suffering from depression and problems with her back and knees. The second ALJ recognized that the prior ALJ decision that Chicora had no disability was binding as to her condition before March 22, 2014. As to Chicoras condition after that date, the ALJ determined that Chicora had submitted new and material evidence that could be considered. But that evidence, the ALJ concluded, did not support a “substantially different finding” regarding Chicoras alleged disability status. Thus, the ALJ held that Chicora was not disabled under the Social Security Act from March 23, 2014 through December 31, 2015, the last date of her insured status. Specifically, the ALJ found that Chicora did not have an impairment or combination of impairments as severe as one of the listed impairments in 20 C.F.R. §§ 404.1520(d), 404.1525, and 404.1526 and that, despite her ailments and moderate limitations, Chicora retained the residual functional capacity to perform some kinds of work for jobs that existed in significant numbers in the national economy. See 20 C.F.R. §§ 404.1520, 416.920.
The Appeals Council denied review, at which point the ALJs decision became final. See 20 C.F.R. § 422.210(a). Chicora then sought judicial review in the U.S. District Court for the Eastern District of Michigan. After Chicora and the Commissioner filed cross-motions for summary judgment, the district court referred the matter to a magistrate judge, who issued a report and recommendation to deny Chicoras motion and grant the Commissioners motion. Chicora v. Commr of Soc. Sec. Admin. (Chicora I), No. 2:18-cv-12636, 2020 WL 2392237 (E.D. Mich. Jan. 27, 2020). The district court overruled Chicoras objections to the report and recommendation, granted the Commissioners motion, denied Chicoras motion, and affirmed the ALJs decision. Chicora v. Commr of Soc. Sec. (Chicora II), No. 18-12636, 2020 WL 1502005 (E.D. Mich. Mar. 30, 2020). Chicora now appeals.
II.
We review de novo a district courts order regarding a determination of Social Security benefits. Emard v. Commr of Soc. Sec., 953 F.3d 844, 849 (6th Cir. 2020). But our review is limited to (1) whether the ALJ used the “correct legal standards” and (2) whether the ALJs findings of fact were supported by substantial evidence in the record. Id. When substantial evidence supports the ALJs denial of benefits, we must affirm the Commissioners conclusions, even if substantial evidence would also have supported the opposite conclusion. Gayheart v. Commr of Soc. Sec., 710 F.3d 365, 374 (6th Cir. 2013). However, even if otherwise substantial evidence supports the Commissioners decision, the ALJs failure to follow “a mandatory regulation that ‘is intended to confer a procedural protection’ for claimants” warrants reversal. Shields v. Commr of Soc. Sec., 732 F. Appx 430, 436 (6th Cir. 2018) (quoting Wilson v. Commr of Soc. Sec., 378 F.3d 541, 547 (6th Cir. 2004)).
III.
A. Application of the Treating Physician Rule
Chicora first argues that the ALJ violated the treating physician rule by failing to give Dr. Jane Castillos medical opinion controlling weight with regard to whether Chicoras impairments met the requirements or their medical equivalence for Listing 1.04 (for certain disorders of the spine), and Listing 12.04 (for certain depressive, bipolar, and related disorders). See 20 C.F.R. Pt. 404, Subpt. P, App. 1. She contends that the ALJ ignored “new evidence” regarding Dr. Castillos credentials, including the fact that 20% of Dr. Castillos practice is devoted to psychiatric illnesses, Dr. Castillos other experience treating mental illness, and Dr. Castillos deposition testimony concerning Chicoras history of orthopedic problems.
The treating physician requirement is a mandatory procedural regulation. Shields, 732 F. Appx at 436–37. A “treating source” is an
acceptable medical source who provides ․ or has provided [the claimant], with medical treatment or evaluation and who has, or has had, an ongoing treatment relationship with [the claimant]․ with a frequency consistent with accepted medical practice for the type of treatment and/or evaluation required for [the] medical condition(s).
20 C.F.R. §§ 404.1527(a)(2), 416.927(a)(2). Because a treating physician is “most able to provide a detailed, longitudinal picture of [a claimants] medical impairment(s) and may bring a unique perspective to the medical evidence,” the ALJ must give a treating physicians medical opinion controlling weight unless it is not “well-supported by medically acceptable clinical and laboratory diagnostic techniques [or] is ․ inconsistent with the other substantial evidence in [the claimants] case record.” §§ 404.1527(c)(2), 416.927(c)(2). The ALJ must provide “good reasons” for not according controlling weight to the treating physician in the benefits decision. Id. In explaining those good reasons and in determining how much weight to give to a treating physicians medical opinion, the ALJ must consider (1) the length of the treatment relationship and the frequency of examination; (2) the nature and extent of the treatment relationship; (3) the supportability of the medical opinion; (4) whether the medical opinion is consistent with the record as a whole; (5) the degree to which the medical opinion is related to a specialists area of specialty; and (6) other factors “which tend to support or contradict the medical opinion.” §§ 404.1527(c)(2)(i)–(ii), 416.927(c)(3)–(6); see Wilson, 378 F.3d at 544. An ALJs failure to abide by the good-reasons requirement “denotes a lack of substantial evidence, even where the conclusion of the ALJ may be justified based upon the record.” Rogers v. Commr of Soc. Sec., 486 F.3d 234, 243 (6th Cir. 2007).
Here, the ALJ gave the following explanation for minimizing the weight of Dr. Castillos medical opinion:
I have considered the deposition testimony of Jane Castillo, MD, the claimants primary physician. First, Dr. Castillo opined the claimant was totally disabled ․, and the severity of the claimants impairments meets listings 1.04 and 12.04․ The first opinion expresses an ultimate conclusion of disability that, in this administrative process, is reserved for the Commissioner of Social Security. Additionally, both opinions are inconsistent with the physicians own treatment notes and examination findings that reveal little functional limitation or physical abnormality as described above. As such, I give the opinions of Dr. Castillo little weight.
The district court held that the above paragraph, in conjunction with the ALJs referenced discussion of Dr. Castillos treatment notes and examination findings, satisfied the good-reasons requirement. Chicora II, 2020 WL 1502005, at *3. We agree.
Chicora does not dispute that the ALJ was correct to refuse to adopt Dr. Castillos ultimate conclusion of disability. See 20 C.F.R. § 404.1527(d). Instead, she focuses on Dr. Castillos opinion with regard to Listings 1.04 and 12.04. In doing so, she largely makes conclusory statements that the ALJ “cherry picked” the record to “subvert[ ]” Dr. Castillos findings. She fails to point to anything in the record that contradicts the ALJs discussion of Dr. Castillos treatment notes and examination findings.
The ALJs explanation goes directly to the supportability and consistency factors. The ALJ cited specific statements in Dr. Castillos own treatment notes and examination findings that fail to support her opinion that Chicora meets the requirements or had an impairment or combination of impairments that medically equaled the severity of Listings 1.04 and 12.04. See Lester v. Soc. Sec. Admin., 596 F. Appx 387, 389 (6th Cir. 2015) (holding that the ALJ “reasonably discounted [the treating physicians] medical opinion” where it was “inconsistent with his own treatment notes from the relevant period”). As the district court noted, the ALJ also addressed the specialization factor by adopting the prior ALJs finding that Dr. Castillos opinion regarding Chicoras alleged depression was outside her area of expertise. Chicora II, 2020 WL 1502005, at *3. Chicora does not explain how Dr. Castillos credentials or the percentage of her practice devoted to psychiatric illnesses constitute new evidence. And although the regulation requires the ALJ to consider all of the factors listed in 20 C.F.R. § 404.1527(c)(2)–(6) when giving a treating physician less-than-controlling weight, the ALJ need only give “good reasons” in the opinion—not an “exhaustive factor-by-factor analysis.” Francis v. Commr of Soc. Sec., 414 F. Appx 802, 804 (6th Cir. 2011) (quoting 20 C.F.R. § 404.1527(d)(2)). Furthermore, “the mere existence of a contrary opinion” or piece of evidence in the record does not undermine the ALJs notice of good reasons. See Tilley v. Commr of Soc. Sec., 394 F. Appx 216, 222 (6th Cir. 2010). The ALJs explanation satisfies the goals of the good-reasons requirement: to enable the claimant to understand her cases disposition and to enable “meaningful review of the ALJs application of the [treating physician] rule.” Wilson, 378 F.3d at 544.
1
B. Substantial Evidence To Support Finding Regarding Listing 1.04(A)
Next, Chicora contends that substantial evidence did not support the ALJs finding that her impairments do not meet or are not medically equivalent to the requirements of Listing 1.04(A). She largely argues that substantial evidence could support a finding that she satisfies the requirements for Listing 1.04(A) and that the ALJ “cherry-picked” the record by ignoring, for example, Dr. Castillos testimony and Chicoras own testimony. Those arguments misconstrue the standard for substantial-evidence review.
We affirm if the ALJs decision is supported by substantial evidence, even if Chicora can show that “substantial evidence also supports the opposite conclusion.” Emard, 953 F.3d at 849 (quoting Crum v. Sullivan, 921 F.2d 642, 644 (6th Cir. 1990)). “Substantial evidence is ‘such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.’ ” Id. (quoting Consol. Edison Co. of N.Y. v. NLRB, 305 U.S. 197, 59 S.Ct. 206, 83 L.Ed. 126 (1938)). In making that determination, we may assess neither credibility nor conflicts in evidence. Id. Thus, claims that the ALJ “cherry-picked” the record are “seldom successful” because they essentially amount to a request that the court “re-weigh record evidence,” which we may not do. DeLong v. Commr of Soc. Sec., 748 F.3d 723, 726 (6th Cir. 2014). To prove that her impairments satisfy a particular Listing, Chicora had to show that her impairments meet each of the medical criteria or that her unlisted impairment or combination thereof is “equal in severity to all the criteria for the one most similar listed impairment.” OBrien v. Commr of Soc. Sec., 819 F. Appx 409, 414–15 (6th Cir. 2020) (quoting Sullivan v. Zebley, 493 U.S. 521, 531, 110 S.Ct. 885, 107 L.Ed.2d 967 (1990)).
Here, the ALJ adequately explained that medical records during the relevant period did not support a finding that Chicora satisfied the requirements of Listing 1.04(A) or their medical equivalence.
2
Specifically, the ALJ pointed to Dr. Castillos notes stating that (1) Chicora had no myalgias, back pain or joint pain in March 2015; (2) Chicora suffered from “no sensory deficits and [her] deep tendon reflexes were symmetrical” in June 2015; and (3) Chicora demonstrated “normal musculoskeletal ranges of motion with no edema or tenderness” in August 2015. We also review the record as a whole when assessing whether substantial evidence supported the ALJs decision. Keeton v. Commr of Soc. Sec., 583 F. Appx 515, 527 (6th Cir. 2014). Dr. Castillos notes do not indicate that Chicora had any limitation of motion, neurological or sensory deficits, or myalgias or falls in September 2014, despite her showing pain on flexion and extension of the lumbosacral spine. In December 2015, another doctors evaluation also noted that her “[p]osture and gait were unremarkable.” Thus, the ALJs determination regarding Listing 1.04(A) was supported by substantial evidence.
C. Substantial Evidence Regarding Vocational Testimony
Finally, Chicora argues that the ALJ did not sufficiently demonstrate that there are jobs in the national economy that Chicora is able to perform. “A vocational experts testimony concerning the availability of suitable work may constitute substantial evidence where the testimony is elicited in response to a hypothetical question that accurately sets forth the plaintiffs physical and mental impairments.” Smith v. Halter, 307 F.3d 377, 378 (6th Cir. 2001).
The ALJ asked the vocational expert to address two hypotheticals. First, the ALJ presented a hypothetical person with Chicoras limitations as the ALJ later found them to exist. Second, the ALJ presented a hypothetical person with the same limitations as the first hypothetical person, but who would also be “off-task, at least, 25% of the work day[ ] and would be absent from work four or more days per month.”
Because the vocational expert testified that no jobs exist in the national economy for the second hypothetical person, Chicora says that no jobs were available for her to perform. She asserts that the ALJs second hypothetical question applies to her job prospects based on Dr. Castillos testimony. But she fails to cite any evidence that the second hypothetical was more applicable to her case than the first, which elicited testimony that she could perform jobs in occupations such as that of an addressor, production inspector, or assembler. An ALJ “may pose a question involving a hypothetical individual with several limitations—and then later decide that those limitations differed from the claimants limitations.” Kessans v. Commr of Soc. Sec., 768 F. Appx 531, 536 (6th Cir. 2019). Chicoras argument about which hypothetical applies to her case amounts to nothing more than an attempt to “partially shift the burden of proof required of a claimant” to prove her residual function capacity “to the Commissioner.” Her v. Commr of Soc. Sec., 203 F.3d 388, 392 (6th Cir. 1999). Ultimately, Chicora offers no reason to question the substantial evidence that supports the ALJs determination that jobs existed in significant numbers in the national economy that Chicora could have performed.
IV.
Accordingly, we affirm.
FOOTNOTES
1
. Chicora also briefly mentions an argument that the ALJ erred because she met the requirements of Listings 12.04 and 12.06. To the extent that she raises an argument distinct from treating physician rule challenge, she has forfeited it. McPherson v. Kelsey, 125 F.3d 989, 995–96 (6th Cir. 1997) (“[I]ssues adverted to in a perfunctory manner, unaccompanied by some effort at developed argumentation, are deemed [forfeited]. It is not sufficient for a party to mention a possible argument in the most skeletal way, leaving the court to ․ put flesh on its bones.” (quoting Citizens Awareness Network, Inc. v. U.S. Nuclear Regulatory Commn, 59 F.3d 284, 293-94 (1st Cir. 1995))).
2
. The criteria for Listing 1.04(A) are as follows: “Evidence of nerve root compression characterized by neuro-anatomic distribution of pain, limitation of motion of the spine, motor loss (atrophy with associated muscle weakness or muscle weakness) accompanied by sensory or reflex loss and, if there is involvement of the lower back, positive straight-leg raising test (sitting and supine).” 20 C.F.R. Pt. 404, Subpt. P, App. 1.
JOHN K. BUSH, Circuit Judge.