Ruben A. v. Commissioner

Background

Ruben A. applied for disability insurance benefits and supplemental security income under the Social Security Act, alleging disability beginning May 6, 2020. After his applications were denied initially and on reconsideration, an administrative law judge held a hearing and issued an unfavorable decision. The Appeals Council denied review. Ruben A. then sought judicial review under 42 U.S.C. § 405(g).

Ruben A. moved for summary judgment, asking the court to reverse the Commissioner’s decision. The Commissioner filed a cross-motion for summary judgment, asking the court to affirm it. The court decided the motions without oral argument.

Issues and Standard of Review

Ruben A. raised four issues: whether the administrative law judge properly evaluated whether his breathing dysfunction medically equaled Listing 3.02; whether the residual functional capacity, meaning the most work a person can do despite medical limitations, fully accounted for his cognitive dysfunction and extreme obesity; whether the administrative law judge properly evaluated Dr. Peter Kao’s medical opinion; and whether the administrative law judge gave clear and convincing reasons for discounting Ruben A.’s statements about his respiratory symptoms.

The court explained that its review was limited. It could disturb the Commissioner’s decision only if the decision lacked substantial evidence or applied incorrect legal standards. Substantial evidence means relevant evidence that a reasonable person could accept as enough to support a conclusion. The court also explained that it had to defer when the evidence reasonably supported more than one interpretation.

Listing 3.02

The court rejected Ruben A.’s argument that his respiratory impairments met or medically equaled Listing 3.02, which concerns chronic respiratory disorders. For a claimant to meet a listing, all required medical criteria must be satisfied. Medical equivalence requires medical findings at least equal in severity and duration to the criteria of the most similar listing; general overall difficulty is not enough.

The court identified the relevant Listing 3.02 thresholds for Ruben A. as an FEV1 of 1.90 liters, an FVC of 2.40 liters, and a DLCO of 12.5. The record showed FEV1 results of 3.05 in January 2022, 2.87 in May 2022, 2.79 in February 2023, and 2.09 in December 2023. Because each FEV1 result was higher than the applicable listing level, the court found that Ruben A. did not meet the FEV1 criteria. The court also found that he had not presented medical findings showing that his obesity and pulmonary dysfunction together equaled the listing. It concluded that he failed to prove disability at this step.

Subjective Symptom Testimony

The court upheld the administrative law judge’s evaluation of Ruben A.’s statements about the severity of his respiratory symptoms. The administrative law judge found that his impairments could reasonably cause the alleged symptoms but that his statements about their intensity, persistence, and limiting effects were not entirely consistent with the record.

The court found reasonable the administrative law judge’s reliance on gaps in treatment, generally normal respiratory and lung examinations outside short-term acute treatment, normal recent imaging and echocardiogram results, normal oxygen saturation readings outside acute treatment, and generally normal gait and coordination findings. The administrative law judge also considered Ruben A.’s reported activities, including traveling, off-roading, fixing bikes, and using a phone’s navigation system, as well as his part-time work and testimony that he sometimes stood for up to six hours during a shift. The court concluded that these reasons sufficiently supported the assessment of his symptoms.

Residual Functional Capacity

The administrative law judge found that Ruben A. could perform limited light work. The restrictions included no climbing of ladders, ropes, or scaffolds; occasional climbing of ramps and stairs; no balancing; occasional stooping, kneeling, crouching, and crawling; avoidance of extreme temperatures, concentrated respiratory irritants, unprotected heights, and certain dangerous or vibrating machinery; simple instructions and tasks; simple work-related decisions; occasional workplace changes; and no production-paced work.

The court rejected Ruben A.’s argument that the residual functional capacity failed to account for his cognitive dysfunction. Although psychological testing showed a full-scale IQ of 61 and some cognitive deficits, the evaluation also stated that his ability to perform simple and repetitive tasks was unimpaired. The administrative law judge additionally relied on evidence that Ruben A. could follow three-step commands, had some intact or adequate cognitive abilities, continued part-time work, and engaged in activities such as watching Netflix, traveling, off-roading, and fixing bikes. The court found that the record supported the administrative law judge’s interpretation.

The court also rejected the obesity argument. The administrative law judge recognized obesity as a severe impairment and considered its effects on exertional, postural, and environmental restrictions. The administrative law judge discussed Ruben A.’s weight, mobility complaints, leg pain, edema reports, gait findings, range of motion, strength, and other examination results. The court concluded that the administrative law judge sufficiently explained how obesity affected the residual functional capacity.

Dr. Kao’s Medical Opinion

Dr. Kao, Ruben A.’s treating pulmonologist, reported respiratory failure, morbid obesity, shortness of breath with minimal exertion, nighttime ventilator use, weak diaphragm muscles, and restrictive lung disease. He opined that Ruben A. had significant limitations in walking, sitting, standing, lifting, and postural activities; would miss more than four days of work per month; and could not tolerate even low-stress work. He dated the limitations to 2015.

The court found that the administrative law judge properly evaluated the opinion under the applicable regulations. Those regulations require consideration of an opinion’s persuasiveness, especially its supportability and consistency, rather than giving automatic controlling weight to a treating physician’s opinion.

The court agreed that the administrative law judge reasonably found Dr. Kao’s opinion not persuasive. The administrative law judge cited the pulmonary test results, which were above the Listing 3.02 threshold; the limited supporting findings; inconsistencies concerning Ruben A.’s use of a breathing device; the lack of evidence that respiratory symptoms worsened with stress; Ruben A.’s part-time work while standing for up to six hours; the absence of support for some manipulative, break, absence, and neck limitations; generally normal physical examinations; daily activities; and the fact that Dr. Kao treated Ruben A. only since January 2022, approximately every nine months, while dating the limitations to 2015. The court concluded that these reasons were supported by substantial evidence and adequately addressed supportability and consistency.

Disposition

The court denied Ruben A.’s motion for summary judgment and granted the Commissioner’s cross-motion for summary judgment. It upheld the administrative law judge’s decision, directed that a separate judgment be entered, and ordered the Clerk of Court to terminate the case. Judge Thomas S. Hixson signed the order on October 10, 2025.