Lager v. Bisignano
- John Docherty
- 0:24-cv-01236
- U.S. District Court · District of Minnesota
- 20
In Scott L. v. Bisignano, Judge Docherty affirmed the Social Security Administration's denial of disability insurance benefits, finding the ALJ's rulings on mental impairments, chronic pain syndrome, and residual functional capacity were supported by substantial evidence.
People who have applied for Social Security disability insurance benefits and whose claims were denied, particularly those with chronic pain conditions, mental health impairments, or connective tissue disorders such as Ehlers-Danlos syndrome, who may be challenging an administrative law judge's findings on severity of impairments or residual functional capacity.
What happened
In Scott L. v. Bisignano (No. 24-cv-1236), Scott L. sought federal court review of the Social Security Administration's decision denying his application for disability insurance benefits. He argued that the administrative law judge (ALJ) — the official who held his hearing and issued the initial ruling — made three errors: wrongly finding his mental impairments (depression and anxiety) were not serious enough to affect his ability to work, failing to separately consider chronic pain syndrome as a potential impairment, and leaving out limitations caused by those conditions when assessing how much work he could still do.
The court reviewed the ALJ's decision under the deferential 'substantial evidence' standard, meaning the ALJ's decision must be upheld if a reasonable person could find the evidence adequate to support it, even if the court might have decided differently. On the mental impairments question, the court found the ALJ properly applied the required evaluation method, noting that Scott L.'s treatment was routine and conservative, his symptoms improved quickly with medication, and his daily activities were largely normal. On chronic pain syndrome, the court found the ALJ was not required to separately list it as an impairment because the ALJ had already considered all the individual sources of pain that would make up that diagnosis — and in any event, any error was harmless because the ALJ fully addressed pain when assessing Scott L.'s capacity for work. On the residual functional capacity assessment, the court found it was supported by substantial evidence and that Scott L. had not identified any specific limitation the ALJ overlooked.
Judge John F. Docherty denied the relief Scott L. requested, granted the relief the Commissioner requested, and affirmed the final decision of the Social Security Administration. The court concluded the ALJ committed no reversible error.
The detailed version
- Lager v. Bisignano · No. 0:24-cv-01236
- John F. Docherty
- Sept. 18, 2025
Background
Scott L. applied for disability insurance benefits (DIB) under Title II of the Social Security Act, alleging disability beginning February 1, 2020. His alleged impairments included Ehlers-Danlos syndrome (EDS, a connective tissue disorder), degenerative disc disease, sleep apnea, hearing loss, chronic pain, chronic fatigue, arthritis, and stroke history. The Social Security Administration (SSA) denied the application at the initial and reconsideration stages. An administrative law judge (ALJ) held a hearing on February 6, 2023, at which Scott L. and a vocational expert (VE) testified. The ALJ issued a written decision on March 8, 2023, finding Scott L. not disabled. The Appeals Council denied review, making the ALJ's decision the Commissioner's final decision subject to judicial review under 42 U.S.C. § 405(g).
Key Medical Evidence
The administrative record contained extensive medical history. In October 2019 — shortly before the alleged onset date — Dr. Matthew Schumann, Ph.D., L.P., diagnosed Scott L. with chronic pain syndrome, among other conditions, following a pain psychology consultation. Dr. Barksdale also listed chronic pain syndrome as a diagnosis in December 2019. Subsequent records from Dr. Elizabeth Osborne, M.D., a chiropractor (Dr. Kevin Hardesty), and a pain management specialist (Dr. Ifechi Anyadioha) documented ongoing neck and back pain with varying degrees of improvement following chiropractic treatment, physical therapy, medication, and injections. By July 2020, Scott L. reported 100% improvement in low back pain and 50% improvement in neck and upper thoracic discomfort. In October 2020 he reported greater than 75% overall improvement. After his EDS diagnosis in late 2021, Dr. Osborne noted a progressive decline over five years. MRI findings showed significant lumbar scoliosis and multilevel degenerative changes, though cervical imaging was described as relatively benign. Scott L. told Dr. Osborne in June 2022 that he was depressed and anxious due to physical limitations.
Dr. Osborne completed several opinion forms. In February 2022, she opined that Scott L. was incapable of even low-stress jobs, could not stand more than two hours or sit more than four hours in an eight-hour workday, and would need unscheduled breaks every 10–15 minutes. In January 2023, she opined his pain would 'constantly' interfere with attention and concentration and that he could not sit or stand for more than two hours each in an eight-hour workday. On a mental residual functional capacity (RFC) form, she indicated marked limitations in interacting with others, concentrating and maintaining pace, and adapting or managing himself. The ALJ found all of Dr. Osborne's opinions not persuasive.
The ALJ's Five-Step Sequential Evaluation
The ALJ applied the standard five-step sequential analysis used to evaluate disability claims:
- Step 1: Scott L. had not engaged in substantial gainful activity since the alleged onset date. - Step 2: Severe impairments included lumbar spine degenerative disc disease, EDS, and bilateral hearing loss. Depression, anxiety, and various other conditions — including hand, cervical, and thoracic pain — were found non-severe. Mental impairments were evaluated under the required 'paragraph B' criteria (four broad functional areas: understanding/remembering/applying information; interacting with others; concentrating/persisting/maintaining pace; and adapting/managing oneself), and the ALJ found only mild limitations in all four areas. - Step 3: No impairment or combination of impairments met or equaled a listed impairment. - RFC Assessment (between Steps 3 and 4): The ALJ found Scott L. capable of light work (as defined in 20 C.F.R. § 404.1567(b)) with additional postural, environmental, and manipulative restrictions — but no mental limitations. The RFC did not include any limitations for mental impairments or chronic pain syndrome as a separate diagnosis. - Step 4: With that RFC, Scott L. could perform his past jobs as parts repair worker, product engineer, sales engineer, and technical salesperson. The ALJ therefore found him not disabled and did not proceed to step five.
Standard of Judicial Review
The court's review was limited to whether substantial evidence on the record as a whole supported the Commissioner's decision, or whether the ALJ committed an error of law. Substantial evidence is less than a preponderance but enough that a reasonable mind would find it adequate to support the conclusion. The court may not reverse simply because substantial evidence would support a different outcome.
Issue 1: Mental Impairments at Step Two
Scott L. argued the ALJ erred in finding his mental impairments non-severe. The court upheld the ALJ's finding. The applicable regulation provides that if the ALJ rates all four paragraph B functional areas as 'mild,' the impairment will generally be found non-severe unless the evidence indicates more than a minimal limitation on basic work activities. The court found the ALJ supported the mild ratings with record citations: Dr. Osborne's June 2022 progress note reflected routine pharmacological management (Cymbalta) without functional restrictions; treatment records documented significant and rapid improvement; the sole treatment note Scott L. cited for concentration problems actually stated that his cognitive concerns 'have resolved'; and the note he cited for anxiety also documented decreased pain, normal attention and concentration, euthymic (stable) mood, and only mild depressive symptoms. The court also found that Scott L.'s report of being 'short-fused' did not establish more than a minimal work limitation or satisfy the 12-month durational requirement. The ALJ was entitled to find Dr. Osborne's mental RFC opinion not persuasive, and Scott L. did not show the ALJ failed to comply with 20 C.F.R. § 404.1520c governing how ALJs must evaluate medical opinion persuasiveness.
Issue 2: Chronic Pain Syndrome at Step Two
Scott L. argued the ALJ erred by not separately considering chronic pain syndrome at step two. The court acknowledged that the record — including records postdating the alleged onset date — established a diagnosis of chronic pain syndrome, and found that diagnosis relevant to the period under consideration. However, the court found no reversible error.
First, under Eighth Circuit authority, an ALJ's failure to list a specific impairment at step two is not an error unless the impairment is 'separate and apart' from other listed impairments. The court found the ALJ already considered all individual pain sources that would comprise chronic pain syndrome — neck pain, back pain, hand pain, cervical pain, and thoracic pain — in connection with the severe impairments EDS and lumbar spine degenerative disc disease. Scott L. did not identify any additional pain the ALJ failed to consider, nor did he explain how a holistic chronic pain syndrome analysis would have differed from the ALJ's pain-by-pain analysis.
Second, even assuming error at step two, it was harmless because the ALJ thoroughly considered all of Scott L.'s pain at the RFC stage. The ALJ reviewed numerous medical records, addressed the lumbar spine MRI showing significant scoliosis and multilevel changes, noted cervical imaging was relatively benign, observed that Scott L. reported walking daily and exercising up to five times a week, found Scott L.'s pain testimony inconsistent with objective evidence and his own statements to providers, and imposed light work with additional restrictions to account for accepted limitations. The court concluded the RFC would not have changed even if chronic pain syndrome had been listed as a severe impairment at step two.
Issue 3: RFC Assessment
Scott L. argued the RFC should have included limitations for mental impairments and chronic pain syndrome. The court rejected this argument. As to pain, the court incorporated its earlier discussion and found substantial evidence supported the RFC's pain-related limitations; Scott L. did not identify any specific limitation the ALJ should have added. As to mental impairments, the only limitation Scott L. pointed to was Dr. Osborne's opinion regarding attention, concentration, persistence, and pace — which the ALJ properly found not persuasive because it conflicted with Dr. Osborne's own treatment notes, clinical findings, conservative treatment approach, and records from other providers lacking mental health findings. The court also found that the hypothetical question posed to the VE was proper because it included all limitations the ALJ found supported by substantial evidence.
Disposition
Judge Docherty denied the relief requested in Scott L.'s memorandum, granted the relief requested in the Commissioner's brief, and affirmed the final decision of the Social Security Administration. Judgment was ordered to be entered accordingly.
Read the full 20-page opinion on CourtListener, the free public archive maintained by the Free Law Project.