Girao v. Commissioner of Social Security

Background

Michael Joseph Girao sought judicial review under 42 U.S.C. § 405(g) of the Social Security Administration’s final decision denying his application for disability insurance benefits. Girao alleged that he became unable to work because of obesity, chronic pain, degenerative disc disease, cervical radiculopathy, cervical spondylosis, mastoiditis, tendonitis, and bilateral occipital neuralgia. He testified that pain in his back, neck, and head limited his ability to sit, stand, perform repetitive tasks, concentrate, and complete daily activities.

Administrative Law Judge Laura Michalec Olszewski found that Girao had several severe physical impairments but retained the residual functional capacity (RFC)—the most he could still do in a work setting—to perform sedentary work with restrictions. The administrative judge found that Girao could not perform his prior work but could perform other jobs identified by a vocational expert, including document preparer, surveillance system monitor, and appointment clerk. The administrative judge therefore found that Girao was not disabled.

The parties filed competing motions for judgment on the pleadings, asking the court to decide the case based on the pleadings and administrative record.

Girao’s Arguments

Girao argued that the administrative judge failed to properly evaluate alleged anxiety, depression, and somatic symptom disorder. He also argued that the administrative judge failed to explain adequately why she found the opinion of Dr. Bruce Heckman unpersuasive. Dr. Heckman had stated that Girao experienced constant, debilitating pain, that his symptoms interfered with attention and concentration, that he would need unscheduled breaks, and that he could not work.

Mental-Impairment Analysis

The court held that the administrative judge did not commit reversible error in addressing Girao’s alleged mental impairments. The court explained that a condition must be a medically determinable impairment, supported by objective medical evidence from an acceptable medical source, before the Social Security Administration must evaluate whether it is severe.

The court found that Girao had not identified objective medical evidence establishing anxiety or depression as medically determinable impairments. The record showed that two consulting psychiatrists concluded there was no psychiatric medically determinable impairment, and another evaluation found only mildly impaired attention and concentration due to physical pain, with an otherwise normal mental-status examination. Although Dr. Tsui diagnosed chronic pain syndrome and somatic symptom disorder, the court found that the diagnosis, standing alone, did not establish a medically determinable impairment under the applicable rules.

The court also noted that Girao did not identify mental impairments in his disability applications or request for an administrative hearing, did not receive regular mental-health treatment, and testified that he was not being treated for mental health. In addition, the administrative judge considered the mental-health evidence during the later RFC analysis. For those reasons, the court concluded that any failure to separately address the alleged mental impairments at the second step of the disability analysis, or to use the required mental-impairment evaluation method, was harmless and did not require a remand.

The court likewise rejected Girao’s argument that the vocational expert’s hypothetical was incomplete because it did not include mental limitations. Because the administrative judge adequately explained why the alleged mental impairments were not medically determinable or severe, the court found no reversible error in the hypothetical.

Dr. Heckman’s Opinion and Symptom Evaluation

The court held that the administrative judge properly evaluated Dr. Heckman’s opinion under the regulations applicable to Girao’s claim. Those regulations require consideration of how well a medical opinion is supported by the source’s own evidence and explanations, and how consistent it is with the complete record.

Regarding supportability, the court found it permissible for the administrative judge to observe that Dr. Heckman’s extreme physical-work limitations were based on Girao’s and his mother’s subjective complaints. Regarding consistency, the court found that the administrative judge’s conclusion that Dr. Heckman’s opinion conflicted with unremarkable objective findings was adequate when read together with the rest of her decision. The administrative judge discussed other medical examinations and testing, including normal strength, normal neurological findings, minimal cervical-disc bulging, and imaging that did not show a structural cause for the reported symptoms.

The court also rejected the argument that the administrative judge improperly substituted her own medical judgment for that of the medical providers. It found that she was entitled to consider objective findings from other providers and resolve conflicts in the medical evidence.

The court further upheld the evaluation of Girao’s subjective complaints. The administrative judge accepted that Girao’s impairments could reasonably produce his symptoms but found that the claimed intensity and limiting effects were not fully consistent with the medical and other evidence. The administrative judge considered objective testing, reported daily activities, treatment history, the reported benefit from an occipital stimulator trial, and evidence concerning how Girao’s mother participated during medical visits. The court found those reasons sufficiently grounded in the record.

Holding and Disposition

The court concluded that the administrative judge’s RFC determination and disability decision were supported by substantial evidence, meaning evidence that a reasonable person could accept as sufficient. Judge James L. Cott denied Girao’s motion for judgment on the pleadings, granted the Commissioner’s cross-motion for judgment on the pleadings, dismissed the case, and directed the Clerk to enter judgment for the Commissioner.