James P. v. Bisignano

Background

James P. applied for Social Security disability insurance benefits (DIB) under Title II of the Social Security Act on February 15, 2022, alleging disability beginning January 1, 2022. His claim was denied initially and on reconsideration. He requested a hearing before an Administrative Law Judge (ALJ).

The ALJ held a hearing on January 9, 2024. A Vocational Expert (VE), Diamond Warren, testified. She classified James P.'s past relevant work as a maintenance electrician (DOT 829.261-018, SVP:7, medium exertional level) and as a bus driver (DOT 913.463-010, SVP:4, medium exertional level).

The ALJ posed hypothetical questions to the VE. When asked to assume a person limited to light-level work with frequent reaching, handling, fingering, and feeling, the VE testified such a person could not perform James P.'s past work. When the ALJ added a medium exertional level, the VE testified the person could not perform work as a maintenance electrician but could perform work as a school bus driver.

The ALJ's Decision

Proceeding through the five-step sequential disability evaluation:

- Step 1: James P. had not engaged in substantial gainful activity during the relevant period. - Step 2: Severe impairments: osteoarthritis of the right knee and obesity. - Step 3: No impairment met or equaled a listed impairment. - RFC (Residual Functional Capacity): The ALJ found James P. capable of medium work with numerous limitations, including frequent (not constant) reaching, handling, fingering, and feeling bilaterally. - Step 4: Based on VE testimony, the ALJ found James P. could perform past relevant work as a school bus driver. The ALJ noted that the Dictionary of Occupational Titles (DOT) indicates a school bus driver requires constant rather than frequent reaching and handling, but accepted the VE's testimony that it was consistent with the DOT and her education and experience. - Step 5 (alternative finding): The ALJ found James P. could also perform jobs existing in significant numbers nationally: hospital cleaner (55,000 jobs), order picker (10,000 jobs), and counter supply worker (35,000 jobs).

The ALJ found James P. not disabled.

Appeals Council Proceedings

James P. sought review from the Appeals Council (AC) on March 12, 2024, submitting a vocational rebuttal report by Karen Starr (the "Starr Report") along with his written request. The Starr Report argued that all three jobs identified at step five cannot be performed within the definition of medium work because they involve little or no seated tasks, while medium work includes approximately two hours of seated tasks per workday.

The AC denied review on January 24, 2025. Its notice stated only that it considered the "reasons" James P. submitted and exhibited his three-page request for review. The Starr Report was not exhibited and was not included in the administrative record. The AC's denial made the ALJ's decision the final decision of the Commissioner.

Standard of Review

A district court reviewing a Social Security final decision asks whether the ALJ's decision complies with relevant legal standards and is supported by substantial evidence — meaning less than a preponderance but enough that a reasonable mind might accept it as adequate. The ALJ must build a logical bridge between the RFC and the evidence. The court may not reverse simply because it would have reached a different conclusion.

However, where it is unclear whether the AC considered additional evidence submitted to it, a court may remand without applying the substantial evidence standard.

Analysis

Issue 1: ALJ's Failure to Resolve Conflict Between VE Testimony and the DOT (Step 4)

Social Security Ruling 00-4p (SSR 00-4p), which governs ALJ use of VE testimony, requires an ALJ to rely primarily on the DOT for information about job requirements, but may use VE testimony to resolve complex vocational issues. Critically, when there is an apparent unresolved conflict between VE testimony and the DOT, the ALJ must: 1. Inquire on the record about the conflict; 2. Elicit a reasonable explanation from the VE; and 3. Explain in the decision how the conflict was resolved.

Here, the ALJ's own decision acknowledged a conflict: the DOT requires constant reaching and handling for school bus drivers, but the RFC limited James P. to only frequent reaching and handling. Despite noting this conflict, the ALJ did not ask the VE about it during the hearing — only asking at the close of the hearing whether her testimony was generally consistent with the DOT. The court found that a generic consistency question does not satisfy SSR 00-4p's requirements, as it would render the obligation to inquire about specific conflicts meaningless.

The court also noted that, contrary to the ALJ's characterization, the VE did not testify that her answers were based on her education and experience.

Without a properly resolved conflict, the ALJ could not rely on the VE's testimony. Under SSR 00-4p, the DOT definition becomes the default, and the DOT requires constant reaching and handling for school bus drivers — exceeding the frequent reaching and handling the ALJ found James P. capable of. The court therefore found the ALJ erred at step four.

Issue 2: Appeals Council's Failure to Address the Starr Report (Step 5)

If a claimant submits additional evidence to the AC, the AC must review the case if the evidence is: (1) new; (2) material; (3) relates to the period on or before the ALJ's decision date; and (4) presents a reasonable probability the outcome would change. 20 C.F.R. § 404.970(a)(5).

The court found the Starr Report satisfied all four criteria: - It was written after the hearing and not cumulative of existing evidence (new). - It was relevant to James P.'s abilities during the period benefits were denied and did not merely reflect post-decision changes (material). - It related to the relevant time period. - Because the ALJ relied exclusively on the VE's testimony at step five, and the Starr Report directly contradicted each of the three jobs the VE identified, there was a reasonable probability the outcome would change.

The AC was therefore required to review the Starr Report. However, the court could not determine whether the AC actually did so. The AC's notice mentioned only James P.'s written request for review; the Starr Report (also three pages) was not exhibited and not included in the administrative record. The court noted that had the AC considered it, one would expect it to have been exhibited and included. Where it is unclear whether the AC considered required evidence, remand is warranted under Eighth Circuit precedent.

Disposition