Gipson v. Bisignano

Background

The plaintiff, Benjamin G., applied for Social Security disability insurance benefits (DIB) on June 24, 2023, alleging a disability onset date of January 1, 2021. He was 30 years old at the time of his application. He served in the United States Air Force from 2010 to 2017, and afterward worked as a brewer and co-owned a brewery. He alleged disability due to major anxiety depressive disorder, degenerative disc disease in the cervical spine at C4 to C5, chronic sprain instability in his left ankle after surgery, and instability in his left knee after surgery.

An ALJ held a hearing on August 26, 2024. The plaintiff was represented by counsel, and both he and a vocational expert testified. The ALJ issued her decision on June 11, 2024 (the opinion contains an apparent internal date inconsistency — the hearing date is listed as August 26, 2024, which postdates the stated decision date of June 11, 2024; the opinion does not resolve this). The ALJ found the plaintiff not disabled and denied his claim.

The Five-Step Sequential Evaluation

Social Security disability determinations follow a five-step process under 20 C.F.R. § 404.1520(a)(4). At step one, the claimant must show he is not engaged in substantial gainful activity. At step two, he must show a severe medically determinable impairment. At step three, if his impairment meets or equals one of the Social Security Administration's listed impairments — a catalog of presumptively disabling conditions — he is found disabled. If not, the evaluation proceeds to step four, where the claimant's residual functional capacity (RFC) — the most he can do despite his limitations — is assessed, and the claimant must show he cannot perform past work. At step five, the burden shifts to the Commissioner to show the claimant can perform other work existing in significant numbers in the national economy.

The ALJ found the plaintiff had the RFC to perform light work, with various physical restrictions and mental limitations including: ability to understand, remember, and carry out simple instructions; only occasional interaction with coworkers, supervisors, and the public; and only occasional changes in a routine work setting. At step five, relying on a vocational expert's testimony, the ALJ found jobs existing in significant numbers in the national economy that the plaintiff could perform, and therefore concluded he was not disabled.

Issues on Appeal

The plaintiff challenged two aspects of the ALJ's decision: (1) the step three conclusion that his mental impairments did not meet or equal listings 12.04 (depressive, bipolar and related disorders), 12.06 (anxiety and obsessive-compulsive disorders), or 12.07 (somatic symptom and related disorders); and (2) the ALJ's mental RFC assessment.

Step Three Analysis

To meet listings 12.04, 12.06, or 12.07, a claimant must satisfy paragraph A criteria and either paragraph B or paragraph C criteria (listing 12.07 has no paragraph C). Paragraph B requires an extreme limitation in one, or marked limitation in two, of four mental functioning areas: understanding/remembering/applying information; interacting with others; concentrating/persisting/maintaining pace; and adapting/managing oneself. Paragraph C requires a medically documented history of the mental disorder over at least two years, plus evidence of ongoing reliance on treatment or a highly structured setting (criterion C1) and only marginal adjustment despite diminished symptoms (criterion C2).

The ALJ found only mild limitations in understanding/remembering/applying information and moderate limitations in the remaining three paragraph B areas, and found the paragraph C criteria were not established. The plaintiff's primary argument was that the ALJ's "sole basis" for this conclusion was her reliance on two state-agency consulting psychologists' opinions. The court rejected this characterization, finding the ALJ conducted over two pages of independent analysis of the applicable criteria — including psychological evaluations, testing, mental status examinations, treatment notes, and the plaintiff's own statements — before referencing the consultants' opinions as additional support.

The plaintiff also challenged the ALJ's evaluation of the consultants' opinions themselves on five grounds. The court rejected each:

1. Non-examining consultants: An ALJ is permitted to credit opinions from consultants who did not personally examine the claimant. The court cited Bowers v. Kijakazi, 40 F.4th 872, 875 (8th Cir. 2022).

2. Alleged factual errors: The plaintiff argued that consulting psychologist Dr. Forgus incorrectly described the context of his acute psychiatric symptoms. The court found the description accurate, noting the plaintiff was still part-owner of the brewery at the time of his August 2024 testimony, was still stressed about school after his hospitalizations (per an October 2023 treatment note), and acknowledged having a new baby.

3. Mention of regulatory familiarity: The plaintiff argued it was improper for the ALJ to note the consultants' familiarity with Social Security regulations. The court found this was a required consideration under 20 C.F.R. § 404.1530c(c).

4. Reliance on credibility statements and legal conclusions: The court found the ALJ did not actually rely on the consultants' credibility statements; the ALJ made her own independent assessment based on objective evidence, including findings that the plaintiff's MMPI-2 test profile reflected overreporting and magnification of mental symptoms.

5. Adequacy of persuasiveness analysis: Under 20 C.F.R. § 404.1520c(b)(2), the two most important factors for evaluating medical opinions are supportability and consistency. The court found the ALJ adequately addressed these by discussing treatment and examination records earlier in the decision, and was not required to restate that evidence again when evaluating the opinions. The court also declined to search the record itself for evidence the plaintiff claimed the ALJ ignored but did not specifically cite.

Mental RFC Analysis

Word Choice Arguments

The plaintiff argued the ALJ wrongly described his mental health treatment as "routine and conservative" given his two psychiatric hospitalizations. The court found the ALJ explicitly acknowledged the hospitalizations but also noted that after the last hospitalization the plaintiff had received no further inpatient or emergency psychiatric treatment.

The plaintiff argued that the ALJ's characterization of a "blunted affect" as a "relatively insignificant clinical sign" was an impermissible lay inference from medical records. The court disagreed, finding the ALJ was comparing isolated records of blunted affect against numerous records showing no significant deficits in memory, cognition, concentration, intellectual functioning, thought process, and social interactions — a determination squarely within an ALJ's mandate. The court also noted that the plaintiff supported his argument with a citation to a medical website not in the administrative record, which the court declined to consider.

The plaintiff challenged the ALJ's statement that reducing mental functioning demands in the RFC should cause a decrease in symptom exacerbations. The court found this commentary did not constitute a factual error in the RFC itself, did not establish a lack of substantial evidence, and amounted to an improper request to reweigh evidence.

Subjective Complaints

The plaintiff argued the ALJ improperly discounted his subjective complaints solely because they could not be independently verified. The court found this mischaracterized the ALJ's reasoning: the ALJ identified two distinct factors weighing against crediting those complaints — unverifiability and the overall weakness of the objective evidence — and the plaintiff failed to address the second factor or the applicable legal framework under 20 C.F.R. § 404.1529 and Polaski v. Heckler, 739 F.2d 1320 (8th Cir. 1984).

Medical Source Statements

The plaintiff's treating psychiatrist, Dr. Keiser, and Veterans Administration psychologist, Dr. Ankarlo, submitted statements. The ALJ found both unpersuasive.

Dr. Keiser: Her submission listed diagnoses, symptoms, and medications, but instead of addressing the plaintiff's functional limitations, directed the reader to neuropsychological testing from August 2021 — testing conducted before her treatment relationship with the plaintiff began in October 2022. She checked a box indicating paragraph C criteria were met but provided no function-by-function analysis of work-related limitations. Under 20 C.F.R. § 404.1513(a)(2), a "medical opinion" is a statement about what the claimant can still do despite his impairments, as distinct from diagnoses or clinical findings under § 404.1513(a)(3). The court agreed with the ALJ that Dr. Keiser's submission did not constitute a "medical opinion" as defined by regulation, and therefore the ALJ was not required to conduct a full persuasiveness evaluation under § 404.1520c.

Dr. Ankarlo: His Veterans Administration disability questionnaire described diagnoses, symptoms, treatment history, and self-reported limitations, but the court agreed with the ALJ that his response to the occupational impact question did not provide a function-by-function assessment of what the plaintiff could still do. The ALJ also noted the questionnaire was completed during a period the plaintiff was experiencing a temporary symptomatic spike and was hospitalized, and that many of Dr. Ankarlo's statements were qualified as reflecting the plaintiff's own self-reports. The plaintiff did not challenge the ALJ's characterization of the July–August 2023 period as a "temporary" spike.

Disposition

Reviewer Note

The opinion contains an apparent internal inconsistency: the ALJ's hearing is listed as August 26, 2024, but the ALJ's decision date is listed as June 11, 2024 — a decision that predates the hearing. This discrepancy is noted in the opinion itself and not explained. This summary reproduces the dates exactly as stated in the opinion without resolving the inconsistency.