Angela M. v. Berryhill

Background

Angela M. sought review under 42 U.S.C. § 405(g) of the Acting Commissioner of Social Security’s denial of her application for disability insurance benefits. She filed her application on June 11, 2014, alleging that her disability began on October 26, 2013. She identified numerous physical and mental conditions, including obesity, anxiety, sleep apnea, a prior carotid artery dissection, migraines, fibromyalgia, dizziness, depression, and post-traumatic stress.

The agency denied her application initially and again on reconsideration. After a hearing, an administrative law judge denied benefits on March 29, 2017. The Appeals Council denied review, making the administrative law judge’s decision final. The parties then filed opposing motions for summary judgment, which ask the court to decide the case based on the administrative record and applicable law.

Administrative Decision

The administrative law judge found that Angela M. had severe impairments consisting of obesity, obstructive sleep apnea, migraine headaches, a history of right internal carotid artery dissection, and fibromyalgia with myofascial pain. The judge found that her mental impairments were not severe because they caused no more than minimal limitations in basic work activities.

The administrative law judge determined that Angela M.’s impairments did not meet or medically equal Listing 11.02, a Social Security regulation concerning certain neurological impairments. The judge assigned her a residual functional capacity—the most she could still do despite her impairments—for light work without work at unprotected heights or near hazards. The judge concluded that she could perform her past relevant work as an order clerk and therefore was not disabled.

Court’s Analysis

The court reviewed whether the administrative law judge committed legal error and whether the decision was supported by substantial evidence, meaning relevant evidence that a reasonable person could accept as sufficient. The court could not reweigh the evidence or reverse merely because the record might also support a different conclusion.

Listing 11.02. Angela M. argued that the administrative law judge failed to consider all parts of Listing 11.02 when evaluating her migraines. The court acknowledged that the judge did not separately discuss subsections 11.02(A) and 11.02(C), which require recurring loss of consciousness and violent muscle contractions. But the court found only one instance of loss of consciousness and no instances of violent muscle contractions. It therefore concluded that the record supported the finding that those subsections were not satisfied.

The court also concluded that the administrative law judge did consider subsections 11.02(B) and 11.02(D). Although the judge did not discuss the migraine evidence at that exact step of the analysis, the judge discussed the evidence later. The court found substantial evidence supporting the determination that Listing 11.02 was not met or medically equaled. It also found that an updated medical-expert opinion was not required because the circumstances requiring one were not present.

Migraines and reported symptoms. The court rejected Angela M.’s argument that the administrative law judge failed to consider relevant migraine evidence. The judge discussed treatment notes concerning her migraines, her prior artery dissection, imaging that showed no acute brain abnormality, multiple normal neurological examinations, and the absence of emergency-room visits or strong headache medication during the relevant period. The court concluded that this evidence supported discounting the reported frequency and severity of her headaches.

The court also found that, even if the judge had erred in noting Angela M.’s decision not to receive recommended Botox injections, any such error would not have changed the outcome because the judge relied on substantial additional evidence.

Dr. Beithon’s opinion. Dr. Beithon opined that Angela M.’s impairments would prevent basic work activities, require unscheduled breaks, cause at least four missed workdays per month, and leave her off task at least 25 percent of the workday. The court concluded that the administrative law judge gave sufficient reasons for discounting this opinion, including treatment records that did not describe acute distress, the lack of relevant emergency-room visits or strong headache medication, and normal neurological examinations and imaging.

The court also concluded that the administrative law judge properly considered the opinions of the state-agency medical consultants. The court explained that the record supported treating those opinions as more consistent with the evidence than Dr. Beithon’s assessment.

Mental impairments. Angela M. argued that the administrative law judge improperly rejected opinions from Ken Little, Dr. Hal Baumchen, Greg Walsh, and state-agency psychological consultants. The court found substantial evidence supporting the judge’s treatment of each set of opinions. The court cited inconsistencies between the opinions and treatment notes, normal observations, testing results, Angela M.’s activities, and the absence of documented mental limitations during the relevant period.

The court further stated that, even if the administrative law judge should have found Angela M.’s mental impairments severe, she had not shown that the alleged error caused harm. The judge had found that she could perform her past work, so the court concluded that the result would have remained the same.

Disposition

The court denied Angela M.’s motion for summary judgment and granted the Acting Commissioner of Social Security’s motion for summary judgment. Judgment was ordered to be entered accordingly, leaving the agency’s denial of disability insurance benefits in place.