Case Name in Social Security Case - Unavailable

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF LOUISIANA
S.A. 	CIVIL ACTION
VERSUS 	NO. 25-166
FRANK BISIGNANO,
COMMISSIONER OF
SOCIAL SECURITY
SECTION: “A” (3)
REPORT AND RECOMMENDATION
Claimant timely filed this action for judicial review1 after the Social Security
Administration (the “Administration”) issued a final denial of her claim for disability
insurance benefits under Title II of the Social Security Act (the “SSA”), 42 U.S.C. §§
416(i) and 423, et seq.2 Claimant asks the Court to reverse the Administrative Law
Judge’s (“ALJ”) holding that Claimant is not entitled to the benefits she seeks and
remand this matter for further administrative proceedings.3 The Administration, via
Commissioner Frank Bisignano,4 urges the Court to affirm the denial of benefits and
dismiss this case.5 Pursuant to 28 U.S.C. § 636(b) and Local Rule 73.2(B), this matter
was referred to the undersigned United States Magistrate Judge. Having carefully
1 See 42 U.S.C. § 405(g).
2 R. Doc. 1.
3 Id. at 2.
4 Frank Bisignano became the Commissioner of Social Security on May 6, 2025.
Pursuant to Rule 25(d) of the Federal Rules of Civil Procedure, Mr. Bisignano should
be substituted as the defendant in this suit. No further action need be taken to
continue this suit by reason of the last sentence of Section 205(g) of the Social Security
Act. 42 U.S.C. § 405(g).
5 R. Doc. 11.
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considered the parties’ briefing6 and the administrative record7 in the light of the
applicable law, it is recommended that Claimant’s appeal be granted and this matter
remanded for further analysis.
I. 	Background
Claimant is a 60 year old female.8 She has a college degree and work
experience as a systems programmer.9 Claimant applied for supplemental security
income and disability insurance benefits on March 21, 2022, and June 4, 2022,
respectively.10 In her March 3, 2022, Function Report, Claimant asserts that she
suffered from daily migraines associated with retrolisthesis and central fissures,
lumbar spondylosis, scoliosis and degenerative disc disease.11 Claimant asserted that
she was rendered disabled by these conditions on January 28, 2022.12 After the
Administration denied her application and request for reconsideration,13 a hearing to
review the claim was held at Claimant’s request.14 The ALJ issued a decision on
August 26, 2024, holding that Claimant was not disabled within the definition of the
SSA15 between January 28, 2022 through the date of the decision.16
6 	The 	Court 	ordered 	the 	parties 	to 	submit 	supplemental 	briefing 	relative 	to
Claimant’s assertion of error at step three. R. Docs. 18, 19, 20.
7 R. Doc. 7.
8 Id. at 71.
9 Id. at 62, 301.
10 Id. at 220–235.
11 Id. at 290.
12 Id. at 229.
13 Id. at 95–99.
14 Id. at 120–121.
15 See 42 U.S.C. §§ 416(i), 423(d).
16 R. Doc. 7 at 23–24.
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The ALJ conducted the five-step sequential analysis required by 20 C.F.R.
§ 404.1520 to consider a claimant’s assertion of disability. As the Fifth Circuit has
explained:
The five steps consider: (1) Is the claimant “doing substantial gainful
activity”? 	(2) 	If 	not, 	does 	the 	claimant 	“have 	a 	severe 	medically
determinable physical or mental impairment” of sufficient duration? (3)
If so, does her impairment(s) meet or equal a listing in Appendix 1 of the
applicable regulations? (4) If not, considering the claimant’s “residual
functional capacity,” can the claimant still do her “past relevant work”?
(5) If not, can the claimant adjust to other work given her residual
functional capacity, age, education, and work experience?
Vasquez v. O’Malley, 2024 WL 4381269, at *1 (5th Cir. Oct. 3, 2024) (quoting 20 C.F.R.
§ 416.920). At steps one through four, the burden of proof is on the claimant to show
she is disabled. Shave v. Apfel, 238 F.3d 592, 594 (5th Cir. 2001). If the claimant can
carry this burden through step three or four, she has established disability and the
inquiry is over. Id. Otherwise, the burden shifts to the Commissioner at step five to
prove the claimant nonetheless retains sufficient functional capacity to adjust to
other employment. Id.
The ALJ found that Claimant satisfied steps one and two. First, Claimant had
not engaged in substantial gainful activity since the alleged onset date of her
disability.17 Second, the ALJ found that Claimant suffered from severe impairments
including “disorders of the spine, [] overweight, migraine headaches, other and
unspecified arthropathies, and vertigo.”18 The ALJ also noted that Claimant suffered
17 Id. at 25.
18 Id. at 26.
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from the non-severe impairments of vertigo19 and medication side effects.20 However,
the ALJ determined that Claimant did not satisfy step three because none of these
impairments or any combination thereof met or equaled an impairment listed in
Appendix One.21 At step four, the ALJ found that Claimant had the residual
functional capacity to perform sedentary work with limitations22 and was therefore
capable of performing past relevant work as a systems programmer.23 Therefore, the
ALJ found that Claimant was not disabled from January 28, 2022, through the date
of its decision.24
Claimant argues that the ALJ failed to offer any explanation why the
Claimant’s impairments did not medically equal Listing 11.02 at step three.25
Claimant also asserts that the ALJ failed to properly evaluate the persistence,
intensity and limiting effects of Claimant’s symptoms relative to migraine headaches
at step four.26
II. 	Standard of Review
This Court’s review of a denial of social security benefits “is exceedingly
deferential and limited to two inquiries: whether substantial evidence supports the
ALJ’s decision, and whether the ALJ applied the proper legal standards when
19 Id. at 26, 35–36.
20 Id. at 28, 31.
21 Id. at 26–27.
22 Id. at 27.
23 Id. at 37.
24 Id. at 39.
25 Id. at 8–11.
26 R. Doc. 9 at 4–8.
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evaluating the evidence.” Taylor v. Astrue, 706 F.3d 600, 602 (5th Cir. 2012).
“Substantial evidence is ‘such relevant evidence as a reasonable mind might accept
as adequate to support a conclusion.’” Greenspan v. Shalala, 38 F.3d 232, 236 (5th
Cir. 1994) (quoting Richardson v. Perales, 402 U.S. 389, 401 (1971)). This must
constitute 	“more 	than 	a mere 	scintilla” of 	evidence 	but may 	be “less 	than a
preponderance.” Spellman v. Shalala, 1 F.3d 357, 360 (5th Cir. 1993). The Court “may
not reweigh the evidence in the record, nor try the issues de novo, nor substitute [its]
judgment . . . even if [the Court concludes that] the evidence preponderates against”
the ALJ’s findings. Johnson v. Bowen, 864 F.2d 340, 343 (5th Cir. 1988). “A finding
of no substantial evidence is appropriate only if no credible evidentiary choices or
medical findings to support” the denial of benefits. Harris v. Apfel, 209 F.3d 413, 417
(5th Cir. 2000) (citing Johnson, 864 F.2d at 343–44). If supported by substantial
evidence, the ALJ’s determination is conclusive and must be affirmed. Richardson,
402 U.S. at 390 (citing 42 U.S.C. § 405(g)).
III. 	Analysis
Claimant argues that the ALJ failed to offer any explanation as to why the
Claimant did not medically equal Listing 11.02 at step three.27 Claimant asserts that
the ALJ conducted no analysis of medical equivalence and relied solely on the fact
that no medical expert had offered an opinion on the issue.28
27 Id. at 8.
28 Id. at 8–9.
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A. 	The ALJ did not adequately explain the basis for the conclusion
that Claimant’s symptoms do not medically equal Listing 11.02
at step three.
Under 20 C.F.R. §404.1526, if a claimant cannot show they “meet” all the
criteria in the listing, they may nonetheless seek to prove they “medically equal” a
listing, which would thereby render them disabled. Bliss v. Colvin, No. 6:14-CV-016-
C, 2015 WL 3507892, at *3 (N.D. Tex. June 2, 2015) (citing Sullivan v. Zebley, 493
U.S. 521, 531 (1990)). “An impairment is medically equivalent to a listed impairment
if it is at least equal in severity and duration to the criteria of any listed impairment.”
Jones v. O'Malley, 107 F.4th 489, 497 (5th Cir. 2024); see 20 C.F.R. § 404.1526(a)
(defining medical equivalence). “For a claimant to qualify for benefits by showing that
his unlisted impairment, or combination of impairments, is ‘equivalent’ to a listed
impairment, he must present medical findings equal in severity to all the criteria for
the one most similar listed impairment.” Sullivan, 493 U.S. at 531; see 20 C.F.R. §
404.1526(b) (“We will find that your impairment is medically equivalent to that
listing if you have other findings related to your impairment that are at least of equal
medical significance to the required criteria.”).
By the explicit terms of 42 U.S.C. §405(b)(1), the ALJ is required to discuss the
evidence in support of Claimant’s claim for disability and to explain why they found
that Claimant was not disabled at that step. Audler, 501 F.3d at 448. Yet the ALJ
need 	not 	provide 	an 	exhaustive 	point-by-point 	discussion. 	Id. 	Additionally,
“[p]rocedural perfection in administrative proceedings is not required as long as the
substantial rights of a party have been affected.” Id. (citing Morris v. Bowen, 837 F.2d
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1362, 1364 (5th Cir. 1988) (internal quotations omitted). If, as Claimant suggests, the
ALJ erred in failing to explicitly analyze medical equivalence, the Court must
determine whether that error was harmless. Id. “The party seeking to overturn the
Commissioner's decision has the burden to show that prejudice resulted from an
error.” Jones v. Astrue, 691 F.3d 730, 734–35 (5th Cir. 2012).
“Migraine headache disorder” is not a listing under Appendix 1, but Social
Security Ruling 19-4p points to Listing 11.02 (epilepsy) as “the most closely analogous
listed impairment” for migraine headaches. Soc. Sec. Ruling 19-4p; Titles II & XVI:
Evaluating Cases Involving Primary Headache Disorders (S.S.A. Aug. 26, 2019)
(“SSR 19-4p”). SSR 19-4p was promulgated to assist adjudicators in evaluating
headache disorders and provides guidance in considering the effects of headaches
when determining residual functional capacity. Id. The ruling instructs adjudicators
to determine whether a headache disorder constitutes a medically determinable
impairment by considering objective medical evidence and subjective allegations,
including whether the record contains a primary headache disorder diagnosis from
an acceptable medical source. Id. Migraines are considered primary headache
disorders and may equal the symptoms detailed in Listing 11.02B (dyscognitive
seizures occurring at least once a week for at least 3 consecutive months despite
adherence to prescribed treatment) or 11.02D (dyscognitive seizures occurring at
least once every 2 weeks for at least 3 consecutive months despite adherence to
prescribed treatment, and marked limitation in one area of functioning). Id.
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To evaluate whether a primary headache disorder is equal in severity and
duration to the criteria in 11.02B, the ALJ must consider:
[A] detailed description from an [acceptable medical source] a typical
headache 	event, including 	all associated phenomena 	(for example,
premonitory symptoms, aura, duration, intensity, and accompanying
symptoms); the frequency of headache events; adherence to prescribed
treatment; side effects of treatment (for example, many medications
used for treating a primary headache disorder can produce drowsiness,
confusion, or inattention); and limitations in functioning that may be
associated 	with 	the 	primary 	headache 	disorder 	or 	effects 	of 	its
treatment, 	such 	as 	interference 	with 	activity 	during 	the 	day 	(for
example, the need for a darkened and quiet room, having to lie down
without moving, a sleep disturbance that affects daytime activities, or
other related needs and limitations).
Id. To evaluate whether a primary headache disorder is equal to 11.02D, the ALJ
must consider other factors in addition to the 11.02B criteria. Id.
Here, the ALJ considered listing 11.02 and concluded:
SSR 19-4p further notes that listing 11.02 (pertaining to a seizure
disorder) 	is 	the 	most 	closely 	analogous 	listing. 	The 	claimant’s
impairment does not meet listing 11.02[,] as there is no evidence of any
type of seizure activity. Further, there is no evidence from a medical
consultant or medical expert that would allow the undersigned to
conclude that her headaches medically equal a listing. The undersigned
fully considered the claimant’s migraine headache disorder, along with
all other medically determinable impairments, when evaluating her
residual functional capacity at Finding 5 of this decision.29
While the ALJ properly identified 11.02 as the most closely analogous listing and
referenced SSR 19-4p, the ALJ failed to follow the directives offered in SSR 19-4p.
The ALJ’s analysis relative to the absence of seizure activity sufficiently
explained why Claimant’s impairment did not meet the criteria for listing 11.02. The
ALJ 	did 	not, 	however, 	adequately 	explain 	the 	reasoning 	behind 	the 	ultimate
29 R. Doc. 7 at 27.
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conclusion that Claimant’s impairment did not equal that listing. See Lopez v.
Kijakazi, No. 3:22-CV-596-CWR-FKB, 2024 WL 667235, at *3 (S.D. Miss. Feb. 1,
2024) (“Given the volume of documentation concerning Lopez's medical treatment for
seizures and migraine headaches, and the fact that the ALJ found enough evidence
in the record to conclude that Lopez has the severe impairments of seizures and
headaches, the ALJ's failure to better explain his conclusions on the medical
equivalence of Lopez's impairments to the Listings is an error that affects Lopez's
substantial rights.”), report and recommendation adopted sub nom. Lopez v. Comm'r
of Soc. Sec., No. 3:22-CV-596-CWR-FKB, 2024 WL 665342 (S.D. Miss. Feb. 16, 2024).
Further, the ALJ’s limited analysis explains only that “there is no evidence from a
medical consultant or medical expert that would allow the undersigned to conclude
that her headaches medically equal a listing.”30 While evidence from a consultant or
expert is one way that a claimant may satisfy Step 3, it is not the only way. See 20
C.F.R. § 404.1526. As the ALJ erred in failing to analyze medical equivalence, the
Court must determine whether this error was harmless. See Audler, 501 F.3d at 448.
B. 	The lack of analysis at Step 3 affected Claimant’s substantial
rights.
The Administration maintains that Claimant’s impairments did not
medically equal listing 11.02 because there was no supporting evidence from a
medical consultant or medical expert.31
30 Id.
31 R. Doc. 11 at 6. Note that SSR 19-4p requires that medically determinable
impairments be established by objective medical evidence from an acceptable medical
source. A licensed physician is an acceptable medical source. 20 C.F.R. §404.1502.
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There 	is, 	however, 	medical 	evidence 	in 	the 	record 	from 	licensed
physicians that supports the conclusion that Claimant’s headaches equaled
“dyscognitive seizures occurring at least once a week for at least 3 consecutive
months despite adherence to treatment.” Soc. Sec. Ruling 19-4p; Titles II &
XVI: Evaluating Cases Involving Primary Headache Disorders (S.S.A. Aug. 26,
2019). A treatment note from January 6, 2022, documents that Claimant
experienced four-hour migraines that occur two to three times a week.32 On
February 23, 2022, EMS was called to an auto dealership, where EMS reported
that Claimant was found “laying face down in the bathroom in vomitus.”33 At
the hospital, Claimant characterized her headache pain as a 10 out of 10.34 On
May 20, 2022, Claimant reported to her doctor a migraine lasting two days.35
On September 21, 2023, Claimant reported that she had near daily headaches
since May 2020.36 Claimant rated the pain of one headache to be level 9 out of
10.37 	Claimant’s 	doctor 	relied 	on 	an 	MRI 	and 	Claimant’s 	diary 	of 	her
headaches38 to diagnose and treat Claimant for chronic migraines.39
32 R. Doc. 9 at 6 (citing R. Doc. 7 at 527).
33 R. Doc. 7 at 823.
34 R. Doc. 9 at 6 (citing R. Doc. 7 at 577).
35 Id. (citing R. Doc. 7 at 514).
36 Id. at 7 (citing R. Doc. 7 at 702).
37 Id. at 5 (citing R. Doc. 7 at 669).
38 Id. (citing R. Doc. 7 at 326–327, 341–342, 355–387).
39 R. Doc. 7 at 514–15; see Soc. Sec. Ruling 19-4p; Titles II & XVI: Evaluating Cases
Involving 	Primary 	Headache 	Disorders 	(S.S.A. 	Aug. 	26, 	2019) 	(providing 	that
“headache journals” are helpful to physicians in making a primary headache disorder
diagnosis and also that physicians may rely on laboratory tests and scans).
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There is evidence of other SSR 19-4p criteria. Claimant’s headaches
required her to lie down for hours.40 See Soc. Sec. Ruling 19-4p; Titles II & XVI:
Evaluating Cases Involving Primary Headache Disorders (S.S.A. Aug. 26,
2019) (instructing consideration of whether the primary headache disorder
causes the claimant to have to “lie down.”). Her headaches have awakened her
from sleep.41 She reported that her eyes felt heavy the next day.42 See Soc. Sec.
Ruling 19-4p; Titles II & XVI: Evaluating Cases Involving Primary Headache
Disorders (S.S.A. Aug. 26, 2019) (instructing consideration of whether the
primary headache disorder causes “a sleep disturbance that affects daytime
activities”). 	There 	is 	also 	evidence 	that 	Claimant’s 	symptoms 	did 	not
significantly improve with treatment.43 See Soc. Sec. Ruling 19-4p; Titles II &
XVI: Evaluating Cases Involving Primary Headache Disorders (S.S.A. Aug. 26,
2019) (instructing consideration of whether claimant adhered to prescribed
treatment).
Given 	the 	volume 	of 	evidence 	relative 	to 	Claimant’s 	migraine
headaches, the ALJ’s failure to explain the conclusions on medical equivalence
is an error that affects Claimant’s substantial rights. See Lopez, No. 3:22-CV-
596-CWR-FKB, 2024 WL 667235, at *3 (holding that remand was appropriate
given the ALJ’s failure to better explain their step three conclusions and the
40 R. Doc. 9 at 5 (citing R. Doc. 7 at 706).
41 Id. (citing R. Doc. 7 at 702).
42 Id.
43 Id. (citing R. Doc. 7 at 667).
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amount of evidence concerning claimant’s primary headache disorder); Smith
v. Comm'r of Soc. Sec. Admin., No. 6:22-CV-06220, 2024 WL 4052737, at *7
(W.D. La. Aug. 12, 2024) (“It is well established that an ALJ does not meet the
statutory standard for step three analysis where no discussion of the claimant's
symptoms in relation to the criteria of the listed impairment is included.”),
report and recommendation adopted, No. 6:22-CV-06220, 2024 WL 4044348
(W.D. La. Sept. 4, 2024). Moreover, because the undersigned recommends
remand for reconsideration of the Listings equivalence, Claimant’s appeal
relative to the determination at step 4 is moot.
IV. 	Recommendation
For the foregoing reasons,
IT IS RECOMMENDED that the decision of the Administrative Law Judge
at step three regarding the equivalence analysis between Claimant’s symptoms and
listing 11.02 be REMANDED for further analysis. On remand, the Administrative
Law Judge may provide further analysis relative to the determination at step 4, if
that step is reached.
A party’s failure to file written objections to the proposed findings, conclusions,
and recommendation in a magistrate judge’s report and recommendation within
fourteen days after being served with a copy shall bar that party, except upon grounds
of plain error, from attacking on appeal the unobjected-to proposed factual findings
and legal conclusions accepted by the district court, provided that the party has been
served with notice that such consequences will result from a failure to object. 28
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U.S.C. § 636(b)(1); Douglass v. United Services Auto. Ass’n, 79 F.3d 1415, 1430 (5th
Cir. 1996) (en banc).
New Orleans, Louisiana, this 22nd day of December, 2025.
__________________________________________
EVA J. DOSSIER
UNITED STATES MAGISTRATE JUDGE
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