Gary D. v. King

Background

Gary D. sought disability insurance benefits under Title II of the Social Security Act. He alleged that he became unable to work on November 1, 2018, because of stage-three Hodgkin lymphoma, depression, “foggy brain,” and back spurs. The Social Security Administration denied the claim initially and on reconsideration.

After a hearing, an administrative law judge (ALJ) found that Gary D. was not eligible for benefits. The Social Security Appeals Council sent the case back to the ALJ because the first decision had not properly evaluated Gary D.’s symptoms under the regulations. After two more hearings, the ALJ again found that Gary D. was not disabled. The Appeals Council declined further review, and Gary D. asked the district court to send the case back for additional proceedings.

The ALJ’s second decision ended at step two of the required five-step disability analysis. The ALJ found that Gary D. had several medically determinable impairments, including vision problems, vertigo, high blood pressure, depression, anxiety, a history of lymphoma after chemotherapy, and obesity. But the ALJ found that none of these impairments, alone or together, significantly limited Gary D.’s ability to perform basic work activities for twelve consecutive months. The ALJ therefore found him not disabled without assessing his residual functional capacity, meaning his ability to work despite his limitations.

Gary D.’s Arguments

Gary D. raised two main arguments. First, he argued that the ALJ improperly evaluated the opinions of state-agency doctors Paul Ossmann and Gregory Salmi. Both doctors concluded that Gary D. could perform medium-level work with additional limits involving posture and exposure to hazards. The ALJ found those opinions not entirely persuasive and gave them limited consideration.

Second, Gary D. argued that the ALJ should have included his mild mental limitations in a residual-functional-capacity assessment and explained why they were omitted.

Medical-Opinion Analysis

The court explained that regulations require an ALJ to address two important factors when evaluating medical opinions: supportability and consistency. Supportability concerns whether the medical source’s own evidence and reasoning support the opinion. Consistency concerns whether the opinion fits with the other medical and nonmedical evidence in the record.

The recommendation concluded that the ALJ adequately addressed supportability. The ALJ connected the doctors’ physical-work limitations to their consideration of Gary D.’s obesity, then explained why the record did not show that obesity was severe or complicated his other impairments. The recommendation stated that this explanation sufficiently showed why the doctors’ reasoning did not support their opinions.

The recommendation also concluded that the ALJ adequately addressed consistency. The ALJ referred to evidence that Gary D.’s lymphoma was in remission, that he had not reported continuing cancer or chemotherapy symptoms during the relevant period, that his other impairments were not severe, and that a primary-care doctor later opined that he had no physical impairments. The ALJ also referred to medical and other records discussed earlier in the decision. The recommendation found these references sufficient to show that the ALJ compared the state-agency doctors’ opinions with the record as a whole.

The recommendation further explained that the ALJ was not required to describe how he considered additional factors beyond supportability and consistency. It rejected Gary D.’s argument that the ALJ’s discussion of those additional factors was inadequate.

Residual Functional Capacity

The recommendation rejected Gary D.’s argument about his mild mental limitations because the ALJ stopped the disability analysis at step two. Under the regulations, an ALJ assesses residual functional capacity only after completing step three and before moving to step four. Because the ALJ found Gary D. not disabled at step two, the ALJ was not required to perform that assessment. The recommendation clarified that, if an ALJ does assess residual functional capacity, the ALJ must consider all medically determinable impairments, including mild limitations; it concluded that this requirement did not apply at the stage reached here.

Recommendation and Notice

Magistrate Judge David T. Schultz recommended that Gary D.’s request for remand be denied and that the defendant’s request to affirm the Commissioner’s decision be granted. The report and recommendation stated that it was not a district court order or judgment and was not directly appealable to the U.S. Court of Appeals for the Eighth Circuit. The parties could file specific written objections within the period stated in the notice.