Full Opinion

NOT RECOMMENDED FOR PUBLICATION File Name: 26a0443n.06 No. 26-5136 UNITED STATES COURT OF APPEALS FOR THE SIXTH CIRCUIT FILED Nov 03, 2026 KELLY L. STEPHENS, Clerk ) REBECCA NOE, ) Plaintiff-Appellant, ) ON APPEAL FROM THE UNITED ) STATES DISTRICT COURT FOR v. ) THE EASTERN DISTRICT OF ) KENTUCKY SOCIAL SECURITY ADMINISTRATION, ) Defendant-Appellee. ) OPINION ) Before: GRIFFIN, BUSH, and HERMANDORFER, Circuit Judges. PER CURIAM. Rebecca Noe appeals the district court’s judgment affirming the Commissioner’s decision denying her applications for disability insurance benefits (DIB) and child insurance benefits (CIB). Noe challenges the ALJ’s findings that her impairments only moderately limited her functional ability and thereby failed to meet or equal the qualifying impairments. For the following reasons, we affirm the district court’s judgment. I. Procedural History In January 2021, Noe, then 42 years old, applied for DIB and for CIB on her father’s record, as the disabled adult child of a retired beneficiary. She claimed that she has been disabled since July 1, 1999, when she was 20 years old, due to a combination of conditions, including bipolar disorder, mental retardation, and attention deficit disorder. Following a hearing, an administrative law judge (ALJ) denied Noe’s applications, finding that she did not prove that she was disabled No. 26-5136, Noe v. SSA from July 1, 1999, through the date of his decision. The Appeals Council denied Noe’s request for review, and Noe appealed to the district court, which affirmed the ALJ’s decisions. II. Noe’s Arguments On appeal, Noe argues that the ALJ failed to account for evidence that did not support his decision and “did not provide a logical explanation for why he rejected so much evidence in opposition to his findings.” Specifically, Noe challenges the ALJ’s findings that she was only moderately, rather than markedly or extremely, limited in four functional areas. Noe also challenges the weight that the ALJ gave to an opinion letter from Dr. Brian Kelty, her treating psychiatrist. III. Standard of Review While we review de novo a district court’s decision in a social security appeal, Moats v. Comm’r of Soc. Sec., 42 F.4th 558, 561 (6th Cir. 2022), “[o]ur review of the ALJ’s decision is ‘limited to determining whether it is supported by substantial evidence and was made pursuant to proper legal standards,’” Napier v. Comm’r of Soc. Sec., 127 F.4th 1000, 1004 (6th Cir. 2025) (quoting Rogers v. Comm’r of Soc. Sec., 486 F.3d 234, 241 (6th Cir. 2007)); 42 U.S.C. § 405(g). Even if we may have reached a different conclusion based on our view of the evidence, “as long as [the ALJ’s decision] is substantially supported in the record,” we must affirm. Rogers, 486 F.3d at 241. To be entitled to CIB, Noe had to show that her disability began before September 3, 2000, when she turned 22 years old. 20 C.F.R. § 404.350(a)(5). And to be entitled to DIB, she had to show that her disability began on or before June 30, 2008, the date that she was last insured. See 42 U.S.C. § 423(a)(1). 2 No. 26-5136, Noe v. SSA IV. Applicable Law The Commissioner uses a five-step sequential evaluation process to determine whether a claimant is disabled within the meaning of the Social Security Act. 20 C.F.R. § 404.1520. The ALJ found that Noe cleared step one because she had not engaged in substantial gainful activity since her alleged onset date. See id. § 404.1520(a)(4)(i). The ALJ also found that Noe had severe medical impairments—ADHD, borderline intellectual functioning, depression, and anxiety— satisfying the second step. See id. § 404.1520(a)(4)(ii). At the third step, the ALJ determined whether Noe’s impairments met or equaled one of the impairments listed at 20 C.F.R. Part 404, Subpart P, Appendix 1. Id. § 404.1520(a)(4)(iii). If her impairment met or equaled those listed, she would qualify as disabled without further analysis. See id. The ALJ examined the requirements of Listings 12.04 (depressive, bipolar and related disorders), 12.06 (anxiety and obsessive-compulsive disorders), and 12.11 (neurodevelopmental disorders). Listings 12.04 and 12.06 have three paragraphs: A, B, and C, and Listing 12.11 has two paragraphs: A and B. 20 C.F.R. pt. 404, subpt. P, app. 1 § 12.00A.2. For Listings 12.04 and 12.06, a claimant’s disorder must satisfy the requirements of both paragraphs A and B or paragraphs A and C; for Listing 12.11, a claimant’s disorder must satisfy the requirement of both paragraphs A and B. Id. The four areas of mental functioning in Paragraph B are the ability to (1) “[u]nderstand, remember, or apply information,” (2) “interact with others,” (3) “concentrate, persist, or maintain pace,” and (4) “adapt or manage oneself.” Id. § 12.00A.2.b. To measure how a claimant’s impairments affect each area, a “five-point rating scale” is used: “none, mild, moderate, marked, and extreme.” Id. § 12.00F.2. To satisfy paragraph B, the claimant’s impairment must result in an “extreme” limitation of one of these areas or a “marked” limitation of two of them. Id. 3 No. 26-5136, Noe v. SSA A limitation is extreme if it wholly prevents the claimant from functioning “independently, appropriately, effectively, and on a sustained basis” in that area. Id. § 12.00F.2.e. A limitation is marked if such functioning is “seriously” limited. Id. § 12.00F.2.d. A limitation is moderate if such functioning is “fair.” Id. § 12.00F.2.c. The ALJ determined that Noe had only moderate limitations in each of the four areas of functioning. Accordingly, the ALJ found that Noe failed to meet the paragraph B criteria and denied relief at step three. The fourth step of the sequential analysis required the ALJ to assess Noe’s residual functional capacity and determine whether she could perform her “past relevant work,” and the fifth step required him to determine if Noe could “make an adjustment to other work.” 20 C.F.R. § 404.1520(a)(4)(iv)-(v). The ALJ ultimately denied relief at step five. On appeal, Noe only challenges the ALJ’s findings at the third step that her impairments were moderate. V. Analysis A. Weight Afforded to Dr. Kelty’s Opinion Letter At the outset, Noe argues that the ALJ failed to adequately explain why he gave very little consideration to her psychiatrist Dr. Kelty’s opinion letter he wrote after reviewing earlier psychological evaluations and school records. In his September 1, 2022 letter, Dr. Kelty stated that he had treated Noe since March 2021. He relayed his “suspected” medical diagnoses and stated that Noe appeared so disorganized at her initial appointment that she was “unable to participate meaningfully in conversation.” Beyond those initial observations, Dr. Kelty simply summarized other observations reported by Noe’s family members and acquaintances. He then concluded that “Noe is unable to maintain gainful and substantial employment, and that this has likely been the case her entire adult life.” But Dr. Kelty’s conclusion that Noe is unable to work “is inherently neither valuable nor persuasive,” because it addresses an “issue[] reserved to the 4 No. 26-5136, Noe v. SSA Commissioner.” 20 C.F.R. § 404.1520b(c)(3)(i). Thus, the opinion was not entitled to any weight and did not require an explanation of its value in the analysis. And the other evidence summarized by Dr. Kelty is elsewhere in the record and was reviewed by the ALJ. In any event, contrary to Noe’s claim, the ALJ did explain its rejection of Dr. Kelty’s opinion. The ALJ explained that his opinion was “conclusory,” went to the “ultimate issue of disability,” and was “inconsistent with his clinical findings.” We find no error here. B. Paragraph B Criteria Next, Noe challenges whether substantial evidence supports the ALJ’s step-three determination that Noe was only moderately limited in the four paragraph B domains. In her view, the evidence shows that she experiences marked or extreme limitations, and the ALJ’s finding that she has a “fair” ability to function was therefore erroneous. See id. app. 1 § 12.00F.2.d. But the burden rested on Noe to prove her disability. Ferguson v. Comm’r of Soc. Sec., 628 F.3d 269, 275 (6th Cir. 2010). On this sparse record, we find substantial evidence to support the ALJ’s decision. 1. Ability to Understand, Retain, and Apply Information To support his finding that Noe’s ability to understand, retain, and apply information was only moderately limited, the ALJ relied on intelligence testing, Noe’s placement in general education classes, her graduation from high school and completion of “some college,” her ability to obtain a learner’s driving permit, and her responses to questioning during the hearing. An initial IQ test, conducted when Noe was in the sixth grade, shows that Noe’s ability “to process verbal information and . . . think with words” was in the “Borderline to Low Average” range. On a second intelligence test performed at the same time, Noe scored in “the [m]oderately [l]ow range overall,” but “demonstrated strengths on subtests measuring memory.” Noe’s overall score on an intelligence test administered when she was 23 years old placed her in the low-average range, and 5 No. 26-5136, Noe v. SSA her verbal IQ fell within the average range, which showed that Noe was “able to compete with peers in various learning activities.” During more recent medical visits, medical professionals routinely deemed Noe’s judgment and insight appropriate, and her insight and memory were described as “intact.” And although Noe received accommodations throughout her education, she was able to graduate from high school while participating in general education classes and attend some college. She also passed her driving permit test, although on the seventh attempt. Finally, the answers that Noe provided during her ALJ hearing might not have been the clearest, but they were responsive to the ALJ’s questions and did not suggest that Noe was unable to understand the proceeding. In sum, while this evidence does suggest impairment in Noe’s ability to understand, retain, and apply information, it does not compel the conclusion that the impairment was more than moderate. 2. Ability to Interact with Others The ALJ found that Noe was only moderately limited in her ability to interact with others because she was “friendly with her family’s housekeeper and previously was able to initiate interactions with patients while working at her father’s medical office,” testing conducted in 1992 found her socialization to be appropriate, she was cooperative and in a normal mood during recent clinical exams, and she “was polite and responsive during the hearing.” Admittedly, the record contains conflicting evidence. Numerous acquaintances reported that Noe had trouble interacting with others since childhood, including that she had difficulty maintaining eye contact and initiating and holding a conversation and that she preferred to be alone. But there was also evidence that Noe enjoyed “being with familiar people” at school and often socialized with a group of friends at lunch and before and after school. Noe’s mother reported in grade school that Noe “likes school and enjoys playing with others and alone.” A ninth-grade report noted no concerns with Noe’s 6 No. 26-5136, Noe v. SSA social competence. And the ALJ’s specific findings regarding Noe’s relationship with the family’s housekeeper, her work at her father’s medical office, 1992 testing, and clinical notes are supported by the record. Noe also appears to have responded politely to questioning during her hearing, as noted. Thus, substantial evidence supports the ALJ’s finding that Noe was only moderately limited in her ability to interact with others. 3. Ability to Concentrate, Persist, and Keep Pace The ALJ acknowledged Noe’s ADHD diagnosis and her documented difficulties with maintaining focus, “following directions[,] and staying on task.” But he found that the evidence did not support a finding that Noe’s ability to concentrate, persist, and keep pace was marked or extremely limited. He also noted that Noe “denied any decreased concentration” during a November 2022 exam and that her attention and perception were deemed “normal” at that time. On appeal, Noe contends that this finding fails to account for third-party statements noting that she was easily distracted and school records showing that she worked at a slow pace. But while the third-party statements provide examples of isolated incidents of distraction and forgetfulness, none of the referenced documents compel the conclusion that Noe was more than moderately limited in this area, particularly where the supporting medical evidence fails to further substantiate her claims. 4. Ability to Adapt and Manage Oneself Finally, Noe challenges the ALJ’s finding that she was only moderately limited in her ability to adapt and manage herself. To support this finding, the ALJ cited Noe’s testimony that she could care for herself independently and care for family pets. Again, the evidence supports these findings. Noe testified that she was able to care for her personal hygiene, feed her pets twice daily and take them for walks, make simple meals, and go out to eat at fast-food restaurants with 7 No. 26-5136, Noe v. SSA her friends. As noted above, she also obtained a learner’s driving permit, graduated from high school, and attended some college. Thus, the ALJ’s finding is supported by substantial evidence. * * * In sum, although the evidence arguably contains evidence that could support findings of more severe limitations with respect to some of the paragraph B criteria, the ALJ’s findings of only moderate limitations are supported by substantial evidence. We therefore must uphold the ALJ’s conclusion that Noe failed to establish disability at step three of the five-step sequential analysis. See Gayheart v. Comm’r of Soc. Sec., 710 F.3d 365, 374 (6th Cir. 2013) (“[We] will affirm the Commissioner’s decision if it is based on substantial evidence, even if substantial evidence would also have supported the opposite conclusion.”). Because Noe challenges only the ALJ’s step-three findings on appeal, she has not identified a reversible error. We therefore AFFIRM the district court’s judgment. 8