Ross B. v. Kijakazi

Background

Ross B. applied for disability insurance benefits on December 11, 2020. He alleged that he became unable to work on August 8, 2019, because of a head injury and back problems. His application was denied initially and on reconsideration. After a hearing at which Ross B. was represented by an attorney, an administrative law judge (ALJ) found severe impairments including degenerative disc disease, obesity, migraine headaches, traumatic brain injury with post-concussive symptoms, and attention deficit hyperactivity disorder.

The ALJ decided that none of the impairments, alone or in combination, met or medically equaled a listed impairment. The ALJ determined that Ross B. could perform light work with physical and mental restrictions. Although those restrictions prevented him from returning to his prior work as a pipe fitter, the ALJ found that he could perform other jobs existing in significant numbers in the national economy. The ALJ therefore found him not disabled. The Appeals Council denied review.

Issues and Analysis

The court reviewed the Commissioner’s decision to determine whether it was supported by substantial evidence on the record as a whole. Ross B. argued that the ALJ improperly evaluated his headaches under the applicable listing and improperly rejected limitations identified by state-agency consultants.

Headache evaluation

The ALJ evaluated Ross B.’s headaches under Listing 11.02, which concerns epilepsy. Social Security Ruling 19-4p identifies Listing 11.02 as the most closely analogous listing for a medically determinable primary headache disorder. But the ruling directs an ALJ to determine whether the headaches are equal in severity and duration to the criteria in Listing 11.02B or 11.02D, rather than asking whether the claimant meets the seizure-specific criteria as written.

The ruling directs the ALJ to consider such matters as the description, frequency, treatment, and side effects of the headaches, along with related functional limitations. For the analysis under Listing 11.02D, the ALJ must also consider whether the overall effects of the headaches cause a marked limitation in areas such as physical functioning, understanding and applying information, interacting with others, concentrating and maintaining pace, or adapting and managing oneself.

The court found that the ALJ did not perform this required analysis. Instead, the ALJ discussed only whether Ross B.’s headaches caused seizures described in Listing 11.02 and did not acknowledge the difference between the listing’s written criteria and the ruling’s instructions for evaluating headaches. The court rejected the Commissioner’s request to independently determine whether Ross B. would have failed to satisfy the proper criteria. The court stated that it could not reweigh the evidence and that the ALJ had to apply the regulations and rulings in the first instance. The court concluded that remand was required.

Consultants’ restrictions

Because the inadequate Listing 11.02 analysis required remand, the court declined to decide Ross B.’s alternative argument concerning the ALJ’s adoption of restrictions identified by state-agency consultants. The court stated that, on remand, the ALJ was not required to adopt any specific limitation from a persuasive medical opinion and was not required to explain why particular limitations identified by the consultants were not adopted. The court described Ross B.’s contrary arguments as without merit.

Disposition

The court found that the ALJ erred in analyzing Ross B.’s impairment under Listing 11.02 and Social Security Ruling 19-4p. It denied Defendant Kilolo Kijakazi’s motion for summary judgment, granted Plaintiff Ross B.’s motion for summary judgment, and remanded the matter to the Commissioner under sentence four of 42 U.S.C. § 405(g). The opinion does not award benefits or decide that Ross B. is disabled; it requires further consideration by the Commissioner.