E.R.R. v. Bisignano

Background

E.R.R. sought judicial review under 42 U.S.C. § 405(g) of the Commissioner of Social Security’s final decision denying her application for disability insurance benefits under Title II of the Social Security Act. She alleged disability beginning April 22, 2019, based on fibromyalgia, short-term memory loss, and stress. The administrative law judge (ALJ) determined that E.R.R. was insured through June 30, 2020, had severe impairments involving a spine sprain or strain and obesity, and had the residual functional capacity (RFC)—the most she could still do despite her impairments—to perform light work. The ALJ concluded that she could perform past relevant work and other jobs existing in significant numbers in the national economy.

The Appeals Council denied review, and E.R.R. filed this action. She challenged two parts of the ALJ’s decision: the finding that fibromyalgia was not a medically determinable impairment and the evaluation of her testimony about the intensity, persistence, and limiting effects of her symptoms. The Commissioner argued that the ALJ’s decision was legally proper and supported by substantial evidence, meaning relevant evidence that a reasonable person could accept as adequate.

Fibromyalgia

The court explained that Social Security Ruling 12-2P recognizes two methods for establishing fibromyalgia: the 1990 American College of Rheumatology criteria and the 2010 criteria. Both methods require evidence of widespread pain and evidence that other disorders were not responsible for the pain. The 1990 criteria also require tenderness at at least 11 of 18 specified points. The 2010 criteria require repeated manifestations of at least six fibromyalgia symptoms, signs, or related conditions.

Dr. Robert Yee diagnosed E.R.R. with fibromyalgia and lumbar strain in November 2019. The ALJ found that Dr. Yee’s record did not explain how the diagnosis satisfied the applicable criteria or show that other causes of E.R.R.’s pain had been excluded. The record also described a normal physical examination without tenderness and noted a work injury while E.R.R. was bending down cleaning. The court held that substantial evidence supported the ALJ’s conclusion that fibromyalgia was not a medically determinable impairment. The court also noted that E.R.R. did not identify another provider’s diagnosis that satisfied the ruling’s requirements.

The court further stated that, even if the ALJ had erred, any error would have been harmless because the ALJ said that E.R.R.’s reported symptoms, including pain, were considered as part of the severe impairments when determining her RFC.

Evaluation of E.R.R.’s Testimony

Because the ALJ found no evidence that E.R.R. was pretending to be ill, the ALJ had to give specific, clear, and convincing reasons for rejecting her statements about the severity of her symptoms. The court found that standard satisfied. The ALJ relied on the November 2019 examination, which showed normal findings and no tenderness, the absence of identified functional limits, a normal lumbar-spine X-ray, limited treatment during part of the relevant period, and E.R.R.’s June 2020 report that she generally felt healthy and was taking no medications.

The court rejected E.R.R.’s arguments that normal examination findings could not be considered because fibromyalgia symptoms may not appear during a physical examination, that her pain reports supported her testimony, and that the ALJ relied improperly on the June 2020 progress note. The court explained that the ALJ considered more than that single note, including the examination findings and limited treatment. It also observed that Dr. Yee recommended a return to full-time work and activity and that the work restrictions documented by chiropractor Dr. Ronald R. Desmarais were temporary. The court concluded that the ALJ reasonably evaluated testimony given in 2024 against evidence from the period between the alleged onset date and the date last insured.

Disposition

The court held that substantial evidence supported both the ALJ’s finding that fibromyalgia was not a medically determinable impairment and the ALJ’s evaluation of E.R.R.’s symptom testimony. Judge Virginia K. DeMarchi affirmed the ALJ’s decision. The clerk was directed to enter judgment and close the file.