Kane v. Bisignano

Background

Patricia K. applied for Social Security disability insurance benefits (DIB) on March 1, 2017, alleging disability from arthritis, shoulder pain, diabetes, and peripheral neuropathy. Her earnings record limited her DIB eligibility to on or before December 31, 2016 — her "date last insured." She amended her alleged disability onset date to November 27, 2015, her 50th birthday.

The Commissioner denied her application initially and on reconsideration. An ALJ held a hearing on February 21, 2019, and issued a decision finding Patricia K. not disabled on April 3, 2019. The Appeals Council denied review. Patricia K. then appealed to federal court in a prior case, and that court granted the Commissioner's motion to reverse and remand, because the ALJ had not reconciled a conflict: the ALJ found Patricia K. was limited to no bilateral overhead reaching, but concluded she could return to her past work as a medical transcriber — a job the Dictionary of Occupational Titles (DOT) lists as requiring frequent reaching, without specifying whether overhead reaching was required. The vocational expert (VE) at the first hearing had not explained how the transcriber job was compatible with the reaching restriction.

On remand, the same ALJ held a new hearing on July 21, 2021. Plaintiff's counsel agreed to proceed directly to VE questioning given the narrow remand issue. The VE testified that the transcriptionist job as generally performed does not require overhead reaching. The ALJ issued a new decision on August 4, 2021, again finding Patricia K. not disabled. The Appeals Council denied review, and this lawsuit followed.

The ALJ's Five-Step Analysis on Remand

The Social Security disability determination follows a five-step sequential process. The ALJ found:

- Step 1: Patricia K. had not engaged in substantial gainful activity since the alleged onset date. - Step 2: She had the following severe impairments: degenerative disc disease of the spine; degenerative joint disease of the hip; degenerative joint disease of the shoulders; and diabetes mellitus with neuropathy. Several other conditions — including anxiety disorder, depressive disorder, dysthymia, and panic disorder — were classified as non-severe. - Step 3: No impairment, individually or in combination, met or equaled a listed impairment in the regulatory Listing of Impairments. - RFC determination: Patricia K. had the residual functional capacity (RFC — the most she could still do despite her limitations) to perform sedentary work, with restrictions including no bilateral overhead reaching, and various postural limitations. - Step 4: Patricia K. had past relevant work as a transcriptionist (sedentary, skilled, SVP 5). She could perform that job as generally performed through the date last insured. - Conclusion: Not disabled.

Issues on Review

Patricia K. raised two arguments: (1) the ALJ improperly classified her mental impairments as non-severe at step two; and (2) the RFC was not supported by substantial evidence.

Standard of Review

The court's review is limited to whether the ALJ's decision complies with relevant legal standards and is supported by substantial evidence — defined as less than a preponderance, but enough that a reasonable mind could accept it as adequate to support a conclusion. The court must affirm if the evidence could support two inconsistent positions and one of them is the ALJ's finding.

Step Two — Mental Impairments

The ALJ classified Patricia K.'s mental impairments as non-severe after evaluating the "paragraph B" criteria — the four broad areas of mental functioning used in the disability regulations: (1) understanding, remembering, or applying information; (2) interacting with others; (3) concentrating, persisting, or maintaining pace; and (4) adapting or managing oneself. The ALJ found no limitations in areas one and four, and only mild limitations in areas two and three. Under 20 C.F.R. § 404.1520a(d)(1), findings of none or mild across all paragraph B criteria generally support a non-severe classification.

The ALJ gave little weight to the opinion of examining physician Dr. Alford Karayusuf, who recommended limitations to simple tasks and superficial social interactions, because his recommendations were not supported by objective evidence in the record, including the psychometric testing he himself cited, and were inconsistent with Patricia K.'s activities of daily living, mental status exam findings, and minimal treatment history. The ALJ gave great weight to the non-examining State Agency psychological consultants, whose opinions were found to be internally well-supported and consistent with the overall record.

The court found no legal error in the ALJ's step-two analysis and found it supported by substantial evidence. The court rejected Patricia K.'s argument that the State Agency physicians failed to ground their opinions in the record, noting that at the initial level, Dr. Karayusuf had not yet examined Patricia K. The court also rejected the argument that one State Agency physician (Dr. Kathleen O'Brien) failed to explain why Dr. Karayusuf's conclusions were incorrect, explaining that it is the ALJ's duty to resolve conflicts among medical opinions, not Dr. O'Brien's. The court noted a minor apparent inconsistency in Dr. O'Brien's report — an initial notation of "severe" followed by a more detailed explanation reaching the opposite conclusion — and characterized the initial notation as a scrivener's error (a clerical mistake). Finally, the court held that even if substantial evidence might support Patricia K.'s position, it cannot reverse the Commissioner's decision when substantial evidence also supports the ALJ's conclusion.

RFC — Step Four

Patricia K. made four arguments against the RFC:

1. Prior concession by the Commissioner. Patricia K. argued the Commissioner had already conceded she could not return to her past work. The court rejected this argument because the cited statement came from a reconsideration-level document, not the ALJ's decision. Each level of administrative review considers the evidence anew, and the ALJ's decision is the final decision of the Commissioner.

2. Mental limitations and Dr. Karayusuf's opinion. Patricia K. argued the RFC failed to incorporate mental limitations. The court rejected this for the same reasons discussed at step two.

3. Handling, fingering, and feeling limitations. The State Agency physicians recommended a limitation on handling, fingering, and feeling based on diabetic neuropathy. The ALJ discounted these opinions because objective medical evidence did not show neuropathy in Patricia K.'s hands until 2018 — after her December 31, 2016 date last insured. Patricia K. had reported no hand neuropathy symptoms prior to that date, and the ALJ reasonably excluded the limitation for the relevant period. The court rejected Patricia K.'s argument that the State Agency physicians must have accounted for the timeline, noting the absence of objective evidence is what mattered, not the physicians' awareness of the date.

4. ALJ substituting her own judgment for medical expertise. Patricia K. argued the ALJ improperly replaced medical opinions with her own lay judgment. The court disagreed, noting the ALJ followed the regulatory framework for weighing medical opinions under 20 C.F.R. § 404.1527 and did not rely on personal observations of the claimant (as had occurred in the Eighth Circuit case Patricia K. cited, Ness v. Sullivan).

5. Similarities to the first, remanded decision. Patricia K. argued that because the ALJ's second decision was substantially similar to her first — which the Commissioner conceded was inadequately supported — the second was equally deficient. The court rejected this, noting the remand was narrow and addressed a specific conflict. On remand, the ALJ resolved that conflict by obtaining VE testimony that the transcriptionist job as generally performed does not require overhead reaching. The Appeals Council itself confirmed the second decision complied with the remand orders.

Disposition

Magistrate Judge Elkins denied Plaintiff's request for relief (Dkt. 16), granted the Commissioner's request for relief (Dkt. 19), and dismissed the matter.