Jacqueline M. J. v. O'Malley

Background

Jacqueline M. J. sought review under 42 U.S.C. § 405(g) of the Commissioner of Social Security’s final decision denying her disability insurance benefits. She applied on December 4, 2020, alleging disability beginning October 1, 2020. The Social Security Administration denied the claim initially and on reconsideration. After a telephone hearing at which counsel represented her, an administrative law judge (ALJ) issued an unfavorable decision on May 27, 2022. The Appeals Council denied further review, making the ALJ’s decision the Commissioner’s final decision.

The ALJ found several severe impairments, including degenerative disc disease, migraine headaches, obesity, obstructive sleep apnea, generalized anxiety disorder, and depressive disorder. The ALJ determined that Jacqueline M. J. did not meet or equal a listed impairment and had the residual functional capacity (RFC)—the most work she could still perform despite her limitations—to perform light work with additional postural, environmental, and mental restrictions. Based on vocational-expert testimony, the ALJ found that she could not perform her past relevant work but could perform other jobs available in the national economy, including marker and mail sorter.

Issues Raised

Jacqueline M. J. raised six challenges. She argued that the ALJ improperly evaluated medical opinions, especially opinions from treating psychologist Amy Strait, Psy.D., and primary-care provider Jennifer Hart, PA-C; incorrectly found that her mental impairments did not meet Listing 12.04; adopted an RFC unsupported by substantial evidence; relied on inaccurate hypothetical questions to the vocational expert; failed to resolve a conflict between the expert’s testimony and the Dictionary of Occupational Titles (DOT); and failed to show that a significant number of jobs existed in her region or in several regions of the country.

Mental-Impairment Finding and Dr. Strait’s Opinion

The court held that substantial evidence supported the ALJ’s finding that Jacqueline M. J. did not meet Listing 12.04, which concerns depressive, bipolar, and related disorders. The listing required, among other things, one extreme or two marked limitations in specified areas of mental functioning and evidence that the disorder was serious and persistent for at least two years.

Dr. Strait rated Jacqueline M. J. as moderately limited in understanding, remembering, or applying information and markedly limited in interacting with others, concentrating, persisting, or maintaining pace, and adapting or managing herself. But Dr. Strait did not check the box stating that the disorder was serious and persistent because she had not treated Jacqueline M. J. long enough to assess the condition over at least two years.

The ALJ found Dr. Strait’s opinion unpersuasive because it was inconsistent with essentially normal mental-status examinations and with activities of daily living, including caring for a one-year-old grandson, tending farm animals, helping manage her adult sons’ finances, and assisting a brother with schizophrenia. The court concluded that the record supported the ALJ’s findings of no more than moderate limitations in the relevant areas. Because the evidence did not establish one extreme or two marked limitations, the court found no error in the conclusion that Listing 12.04 was not satisfied.

The court also held that the ALJ did not legally err in evaluating Dr. Strait’s opinion. Under the applicable regulations, an ALJ must consider the persuasiveness of medical opinions but must explain supportability and consistency; the ALJ need not defer to a treating provider or separately explain every other regulatory factor. Although the ALJ did not discuss Dr. Strait’s examining relationship with Jacqueline M. J., the court stated that this was a factor the ALJ was not required to explain. The ALJ adequately explained that the opinion lacked support and consistency in light of the other evidence.

RFC and Physical-Impairment Evidence

The court held that substantial evidence supported the RFC limitations addressing back pain and migraine headaches. The RFC limited Jacqueline M. J. to light work and included restrictions on climbing, balancing, bending, reaching, exposure to hazards, extreme temperatures, humidity, light, noise, and vibration.

The ALJ considered spinal imaging showing mild to moderate disc narrowing, treatment involving physical therapy, branch blocks, and radiofrequency ablation, and migraine treatment involving medication, Botox, nerve blocks, physical therapy, and chiropractic therapy. The court rejected the argument that the ALJ substituted personal judgment for medical evidence.

The court also upheld the ALJ’s treatment of opinions from Ms. Hart and Dr. Strait. The ALJ found Ms. Hart’s work-excuse statements temporary and of limited persuasive value, and found that her RFC assessment was not supported by her generally normal examination findings. The court concluded that the ALJ adequately explained the opinions’ lack of support and consistency under 20 C.F.R. § 404.1520c. It likewise found sufficient the ALJ’s explanation for rejecting Dr. Strait’s more severe RFC limitations.

Vocational-Expert Testimony and DOT Conflict

The court held that the vocational expert’s testimony was substantial evidence supporting the finding that Jacqueline M. J. was not disabled. Because the RFC was supported by substantial evidence, and the ALJ’s hypothetical questions accurately reflected the RFC’s exertional, postural, environmental, and mental limitations, the expert’s testimony provided a reliable basis for the decision.

The court also found that the ALJ complied with Social Security Ruling 00-4p, which governs conflicts between vocational-expert testimony and the DOT. The ALJ asked whether the testimony was consistent with the DOT, and the expert said it was. The court explained that the DOT was silent about pace and low-stress work, so there could be no conflict on those subjects. It further determined that the DOT descriptions and worker-function ratings for marker and mail sorter did not conflict with limitations to simple, routine tasks and simple work-related decisions. The court likewise found no conflict between those limitations and the jobs’ DOT reasoning levels.

Number of Available Jobs

The court rejected the argument that the Commissioner had to provide a regional breakdown of the jobs identified by the vocational expert. The expert identified 143,200 representative jobs nationally. Although the record did not state how those jobs were distributed by region, the court found the total sufficient, particularly because marker and mail sorter were broadly defined occupations and were not shown to be peculiar to particular regions.

The court concluded that the Commissioner met the step-five burden of showing that a sufficient number of jobs were available to Jacqueline M. J. in the national economy.

Disposition

The court denied Jacqueline M. J.’s motion and granted the Commissioner’s motion. Judgment was entered accordingly, leaving the Commissioner’s denial of disability insurance benefits in place.