Bell v. Commissioner of Social Security

UNITED STATES DISTRICT COURT
DISTRICT OF MARYLAND
Chambers of
Douglas R. Miller
United States Magistrate Judge
101 West Lombard Street
Baltimore, Maryland 21201
MDD_DRMChambers@mdd.uscourts.gov
(410) 962-7770
February 10, 2026
LETTER TO ALL COUNSEL OF RECORD
Re: Shane B. v. Frank Bisignano, Commissioner, Social Security Administration1
Civil No. 24-3607-DRM
Dear Counsel:
On December 13, 2024, Plaintiff Shane B. (“Plaintiff”) petitioned this Court to review the
Social Security Administration’s (“SSA’s” or “Commissioner’s” or “Defendant’s”) final decision
to deny Plaintiff’s claim for Social Security benefits. ECF No. 1. This case was then referred to
me with the parties’ consent. See 28 U.S.C. § 636; Loc. R. 301. I have considered the record in
this case and the parties’ briefs. ECF Nos. 9, 12, 14, 15. I find that no hearing is necessary. See
Loc. R. 105.6. The Court must uphold the decision of the SSA if it is supported by substantial
evidence and if the SSA employed proper legal standards. See 42 U.S.C. §§ 405(g), 1383(c)(3);
Craig v. Chater, 76 F.3d 585, 589 (4th Cir. 1996). Under that standard, I will REVERSE the
Commissioner’s decision. This letter explains why.
I. PROCEDURAL BACKGROUND
Plaintiff filed for Title II Disability Insurance Benefits (“DIB”) and Title XVI
Supplemental Security Income (“SSI”) on January 18, 2023, alleging a disability onset date of
August 31, 2022 in both applications. Tr. 19. Plaintiff was denied initially on July 10, 2023, and
upon reconsideration on October 26, 2023. Tr. 123-130. On April 5, 2024, an Administrative Law
Judge (“ALJ”) held a hearing. Tr. 35-66. Following the hearing, on June 25, 2024, the ALJ
determined that Plaintiff was not disabled within the meaning of the Social Security Act2 during
the relevant time frame. Tr. 16-34. The Appeals Council denied Plaintiff’s request for review, Tr.
1-8, so the ALJ’s decision constitutes the final, reviewable decision of the SSA, Sims v. Apfel, 530
U.S. 103, 106–07 (2000); see also 20 C.F.R. § 422.210(a).
1 Plaintiff filed this case against Martin O’Malley, the Acting Commissioner of Social Security on
December 13, 2024. ECF No. 1. Frank Bisignano became the Commissioner of Social Security on
May 7, 2025. Accordingly, Commissioner Bisignano has been substituted as this case’s Defendant
pursuant to Federal Rule of Civil Procedure 25(d). See Fed. R. Civ. P. 25(d).
2 42 U.S.C. §§ 301 et seq.
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Shane B. v. Frank Bisignano
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II. THE ALJ’S DECISION
Under the Social Security Act, disability is defined as the “inability to engage in any
substantial gainful activity by reason of any medically determinable physical or mental impairment
which can be expected to result in death or which has lasted or can be expected to last for a
continuous period of not less than 12 months[.]” 42 U.S.C. § 423(d)(1)(A); 20 C.F.R.
§§ 404.1505(a), 416.905(a). The ALJ is required to evaluate a claimant’s disability determination
using a five-step sequential evaluation process. See 20 C.F.R. §§ 404.1520, 416.920. “Under this
process, an ALJ evaluates, in sequence, whether the claimant: ‘(1) worked during the alleged
period of disability; (2) had a severe impairment; (3) had an impairment that met or equaled the
requirements of a listed impairment; (4) could return to [their] past relevant work; and (5) if not,
could perform any other work in the national economy.’” Kiser v. Saul, 821 F. App’x 211, 212
(4th Cir. 2020) (citation omitted) (quoting Hancock v. Astrue, 667 F.3d 470, 472 (4th Cir. 2012)).
Here, at step one, the ALJ determined that Plaintiff had not engaged in substantial gainful
activity since August 31, 2022, the alleged onset date. Tr. 21. At step two, the ALJ found that
Plaintiff suffered from the severe impairments of “squamous cell carcinoma of supraglottis in
remission status post radiation; knee arthritis; obesity and rule out carpal tunnel syndrome/hand
pain; depressive disorder; anxiety disorder; and, post traumatic stress disorder.” Tr. 22. At step
three, the ALJ determined that Plaintiff “does not have an impairment or combination of
impairments that meets or medically equals the severity of one of the listed impairments in 20 CFR
Part 404, Subpart P, Appendix 1.” Tr. 22. The ALJ also determined that Plaintiff retained the
residual functional capacity (“RFC”) to:
perform light work as defined in 20 CFR 404.1567(b) and 416.967(b) except he could
frequently climb ramps and stairs, but could not climb ladders, ropes or scaffolds;
could occasionally kneel, crouch and crawl; occasionally interact with the general
public in person or on the phone; could perform work requiring no more than
occasional speaking/talking. He could handle, finger and feel frequently with the
bilateral upper extremities.
Tr. 24. The ALJ determined that Plaintiff could not perform any past relevant work but could
perform jobs that existed in significant numbers in the national economy such as classifier, router,
and non-postal mail clerk. Tr. 28-30. Therefore, the ALJ concluded that Plaintiff was not disabled.
Tr. 30.
III. LEGAL STANDARD
The scope of the Court’s review is limited to determining whether substantial evidence
supports the ALJ’s factual findings and whether the decision was reached through the application
of the correct legal standards. See Coffman v. Bowen, 829 F.2d 514, 517 (4th Cir. 1987). “The
findings of the [ALJ] . . . as to any fact, if supported by substantial evidence, shall be conclusive .
. . .” 42 U.S.C. § 405(g). Substantial evidence is “evidence which a reasoning mind would accept
as sufficient to support a particular conclusion.” Laws v. Celebrezze, 368 F.2d 640, 642 (4th Cir.
1966). It is “more than a mere scintilla but may be somewhat less than a preponderance.” Id. In
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Shane B. v. Frank Bisignano
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conducting the “substantial evidence” inquiry, my review is limited to whether the ALJ analyzed
the relevant evidence and sufficiently explained their findings and rationale in crediting the
evidence. See, e.g., Sterling Smokeless Coal Co. v. Akers, 131 F.3d 438, 439–40 (4th Cir. 1997);
DeLoatche v. Heckler, 715 F.2d 148, 150 (4th Cir. 1983) (“Judicial review of an administrative
decision is impossible without an adequate explanation of that decision by the [ALJ].”).
IV. ANALYSIS
On appeal, Plaintiff argues that the ALJ’s RFC determination is not supported by
substantial evidence for two reasons. First, Plaintiff contends that the ALJ failed to build a logical
bridge between the evidence of Plaintiff’s breathing difficulties following treatment for laryngeal
cancer and the RFC limitation restricting him to only occasional speaking and talking. ECF No.
12 at 8. Plaintiff asserts that this limitation does not address his shortness of breath on exertion,
particularly given the standing and walking requirements of light work, and that the ALJ did not
explain how Plaintiff could sustain such activity for a full workday. Id. at 9. Second, Plaintiff
argues that the ALJ improperly evaluated the opinion of consultative examiner Dr. Melanie
Montemayor, who concluded that Plaintiff was limited to less than sedentary work. Id. at 12-14.
Plaintiff maintains that the ALJ failed to adequately analyze the supportability and consistency of
Dr. Montemayor’s opinion. Id.
In response, the Commissioner contends that the ALJ applied the correct legal standards
and that substantial evidence supports the decision. ECF No. 14 at 7. The Commissioner argues
that the ALJ reasonably limited Plaintiff to light work with additional restrictions that adequately
accounted for Plaintiff’s medically determinable impairments, including residual effects of throat
cancer, mental health conditions, and musculoskeletal complaints. Id. at 15. The Commissioner
states that Plaintiff’s arguments improperly ask the Court to reweigh the evidence, which is beyond
the scope of judicial review. Id. at 13. The Commissioner asserts that the ALJ properly found Dr.
Montemayor’s opinion unpersuasive because it was inconsistent with the broader medical record,
relied heavily on Plaintiff’s subjective complaints, and was unsupported by objective findings. Id.
at 10-14. The Commissioner maintains that the ALJ’s decision contains sufficient explanation to
permit meaningful judicial review and should therefore be affirmed. Id. at 14.
On reply, Plaintiff reiterates that the ALJ failed to provide a logical explanation linking the
evidence of Plaintiff’s breathing difficulties to the RFC limitation of only occasional speaking and
talking, leaving the Court unable to meaningfully review the decision. ECF No. 15 at 1. Plaintiff
further argues that limiting speech does not address exertional shortness of breath inherent in light
work and that the Commissioner’s reliance on normal respiratory findings not cited by the ALJ
constitutes impermissible post hoc rationalization, which requires remand. Id. at 2.
When evaluating medical opinions in claims filed on or after March 27, 20173, an ALJ
must, as the Fourth Circuit recently explained:
3 See Revisions to Rules Regarding the Evaluation of Medical Evidence, 82 Fed. Reg. 5844, 5853
(Jan. 18, 2017).
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Shane B. v. Frank Bisignano
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“evaluate the persuasiveness” of that evidence by applying a five-factor test, 20
C.F.R. § 404.1520c(a); see also id. § 404.1520c(b)(2), -(c). The factors are: (1)
supportability, (2) consistency, (3) relationship with the claimant, (4) specialization,
and (5) other factors. Id. § 404.1520c(c)(1)-(5).
Although the Social Security Administration must ultimately “stat[e] the ... reason
or reasons upon which” its final decision “is based,” 42 U.S.C. § 405(b)(1), an ALJ
need not explain in detail how he “evaluate[d] the persuasiveness,” 20 C.F.R.
§ 404.1520c(a), of each piece of evidence in the record. The ALJ only needs to say,
for each “medical source” in the record, how each of the first two factors applies—
that is, whether that source’s conclusions are supportable by medical evidence and
consistent with the rest of the record. Id. § 404.1520c(b)(1), -(2). An ALJ must
consider all five factors, but need not discuss any save the first two unless those
other factors are dispositive. Id. § 404.1520c(b)(3); see 42 U.S.C. § 405(b)(1).
Drumgold v. Comm’r of Soc. Sec., 144 F.4th 596, 604-05 (4th Cir. 2025).
The relevant regulations define these first two factors as follows:
(1) Supportability. The more relevant the objective medical evidence and
supporting explanations presented by a medical source are to support his or her
medical opinion(s) or prior administrative medical finding(s), the more persuasive
the medical opinions or prior administrative medical finding(s) will be.
(2) Consistency. The more consistent a medical opinion(s) or prior administrative
medical finding(s) is with the evidence from other medical sources and nonmedical
sources in the claim, the more persuasive the medical opinion(s) or prior
administrative medical finding(s) will be.
20 C.F.R. § 404.1520c(c)(1)-(2).
Here, the ALJ’s consideration of Dr. Montemayor’s opinion consisted of the following
paragraph:
On May 27, 2023, the claimant presented to Melanie Montemayor, MD for an internal
medicine consultative examination, who opined that the claimant had no limits in
sitting; could stand and walk 1-2 hours at a time and 2 out of 8 hours total, due to back
pain; lift and carry 5 lbs. frequently and 10 lbs. occasionally, while occasionally
bending, stooping, crouching and squatting due to back pain; can frequently grasp,
handle and feel due to bilateral hand numbness and rule out carpal tunnel syndrome;
communicative limits due to dysarthria, but no other limits. This is supported by the
claimant’s clinical examination presentation which revealed allegations of 10 out of
10 pains, some reduced lumbar spine range of motion with otherwise all normal range
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Shane B. v. Frank Bisignano
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of motion. Grip strength was 5 out of 5 bilaterally. The claimant could squat and rise
with difficulty but was not using an assistive device and had an asymmetric gait. His
voice was hoarse (Exhibit 6F). The claimant was laid off a job in August of 2022,
where he performed heavy to very heavy work. Nothing in the evidence of record or
testimony explains the change from very heavy to sedentary (Exhibit 12F).
Accordingly, it is not persuasive.
Tr. 28. (emphasis added).
The italicized sentence comports with the supportability requirement for the ALJ’s analysis
of Dr. Montemayor’s opinion. Tr. 28. In particular, the ALJ references Dr. Montemayor’s clinical
examination and her conclusions which, the ALJ finds, supports her proposed limitations.
See Michael C. v. Kijakazi, No. BAH-22-0129, at *4 (D. Md. Oct. 24, 2022) (finding that ALJ
adequately assessed supportability when ALJ noted provider’s observations and results of
examinations). To the extent the ALJ is expressing any perceived inconsistencies between Dr.
Montemayor’s opinion and the observations on which it was based, internal inconsistencies go to
an opinion’s supportability.4
The ALJ’s evaluation of Dr. Montemayor’s opinion does not, however, comport with the
regulatory requirement to assess consistency with other record evidence. The ALJ did not explain
how any “evidence from other medical and nonmedical sources” was inconsistent with Dr.
Montemayor’s opinion, as required by 20 C.F.R. § 404.1520c(c)(2). See, e.g., Shayna R. v.
Kijakazi, No. BAH-21-1803, 2022 WL 1239876, at *5 (D. Md. Apr. 27, 2022) (finding that the
ALJ adequately assessed consistency when the ALJ noted specific instances of inconsistency
between medical opinion and the record); Amanda C. v. Dudek, No. CDA-23-2877, 2025 WL
722691, at *3 (D. Md. Mar. 6, 2025) (concluding that remand was not warranted where the ALJ
adequately assessed consistency by comparing Plaintiff’s testimony regarding her ability to care
for her five-year old child, instances in the record identifying waxing and waning symptoms, and
clinical imaging which demonstrated only mild osteoarthritis of the hips to the medical opinion);
Denise J. v. Dudek, No. CDA-24-0040-CDA, 2025 WL 918426, at *4 (D. Md. Mar. 26, 2025)
(finding that the ALJ adequately assessed consistency when, in comparison to the medical opinion,
referencing specific findings of normal cognitive functioning, pleasantness, and cooperative
attitude on evaluations and Plaintiff’s reports that anxiety is well-managed on medication from the
record).
The ALJ discounted Dr. Montemayor’s opinion on the ground that “[n]othing in the
evidence of record or testimony explains the change from very heavy to sedentary (Exhibit 12F).”
Tr. 28. It was reasonable for the ALJ to look for evidence as to how Plaintiff became capable of
4 20 C.F.R. § 404.1502(d) defines “medical source” as “an individual” who meets certain licensing
or certification requirements. 20 C.F.R.§ 404.1502(e) provides examples of “non-medical
sources,” all of which are categories of individuals. In this context, “evidence from other medical
sources and nonmedical sources” must therefore refer to evidence from other individuals and not
from the same provider.
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Shane B. v. Frank Bisignano
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lifting and carrying only five pounds frequently and ten pounds occasionally, when he was able to
do work requiring him to lift and carry much more prior to his claimed disability onset date some
9 months earlier. But this analysis has two defects.
First, its reasoning seemingly imposes a heightened requirement that the record contain
other evidence affirmatively corroborating Dr. Montemayor’s assessed limitations. However, 20
C.F.R. § 404.1520c(c)(2) merely states that “[t]he more consistent a medical opinion . . . is with
the evidence from other medical sources and nonmedical sources in the claim, the more persuasive
the medical opinion . . . will be.” Second, while the ALJ cited Exhibit 12F—which consists of
physical therapy treatment notes dated February 5, 2024, through March 21, 2024, addressing
Plaintiff’s lifting, squatting, and weight-bearing abilities—he did not explain how these records
were inconsistent with Dr. Montemayor’s opinion, as was required under 20 C.F.R.
§ 404.1520c(b)(2). See Tr. 585-631. For both reasons, the Court cannot meaningfully review the
ALJ’s consistency analysis, and remand is warranted.
Defendant is correct that an ALJ’s decision must be read “as a whole.” Keene v. Berryhill,
732 F. App’x 174, 177 (4th Cir. 2018). However, the Court cannot fill the logical gaps in the ALJ’s
reasoning. The regulation required the ALJ to conduct and explain a consistency analysis of Dr.
Montemayor’s opinion. 20 C.F.R. § 404.1520c(b)(2). That did not occur, and “[o]ur circuit
precedent makes clear that it is not the Court’s role to speculate as to how the ALJ applied the law
to its findings or to hypothesize the ALJ’s justifications that would perhaps find support in the
record.” Fox v. Colvin, No. 14-2237, 2015 WL 9204287, at *4 (4th Cir. Dec. 17, 2015).
Therefore, remand is necessary so that the ALJ can provide an analysis of Dr.
Montemayor’s opinion that fully comports with 20 C.F.R. § 404.1520c. The Court takes no
position on what level of persuasiveness, if any, should attach to Dr. Montemayor’s opinions.
Because the case is being remanded on the grounds described above, I need not address other
arguments that appear in Plaintiff’s brief. On remand, the ALJ is welcome to consider these
arguments and make any required adjustments to the opinion. Additionally, in remanding for
further explanation, the Court expresses no opinion as to whether the ALJ’s conclusion that
Plaintiff is not entitled to benefits is correct.
V. CONCLUSION
For the reasons set forth herein, pursuant to sentence four of 42 U.S.C. § 405(g), the SSA’s
judgment is REMANDED.
Despite the informal nature of this letter, it should be docketed as a Memorandum Opinion.
A separate implementing Order follows.
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Shane B. v. Frank Bisignano
Civil No. 24-3607-DRM
February 10, 2026
Page 7
Sincerely,
/s/
Douglas R. Miller
United States Magistrate Judge
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