Brewer v. Bisignano

THE UNITED STATES DISTRICT COURT
DISTRICT OF UTAH
ANGELA B.,
Plaintiff,
v.
FRANK BISIGNANO,1
Commissioner of Social Security,
Defendant.
MEMORANDUM DECISION
AND ORDER
Case No. 1:25-cv-00023-JCB
Magistrate Judge Jared C. Bennett
PROCEDURAL B ACKGROUND2
Plaintiff Angela B. (“Plaintiff”) alleges disability due to various physical and mental
impairments. Plaintiff applied for Disability Insurance Benefits under Title II of the Social
Security Act3 in August 20214 and Supplemental Security Income under Title XVI of the Social
Security Act5 in August 2022.6 Plaintiff’s claims were denied initially7 and upon
1 Frank Bisignano is now the Commissioner of Social Security. Under Fed. R. Civ. P. 25(d), he
has been substituted as the Defendant in this case. ECF No. 10.
2 Under 28 U.S.C. § 636(c) and Fed. R. Civ. P. 73, all parties have consented to Judge Jared C.
Bennett conducting all proceedings in this case, including entry of final judgment. ECF No. 6.
3 42 U.S.C. §§ 401-434.
4 ECF No. 9, Administrative Record (“AR ___”) 255-61.
5 42 U.S.C. §§ 1381-1383f.
6 AR 240-52.
7 AR 116-25.
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reconsideration.8 On November 9, 2023, Plaintiff appeared with counsel for a hearing before an
Administrative Law Judge (“ALJ”).9 The ALJ issued a written decision on January 11, 2024,
denying Plaintiff’s claims.10 Plaintiff appealed the adverse ruling, and, on January 3, 2025, the
Appeals Council denied her appeal,11 making the ALJ’s decision final for purposes of judicial
review.12 Plaintiff then filed suit in this court seeking review of Commissioner of Social Security
Frank Bisignano’s (“Commissioner”) final decision.13
S TANDARD OF REVIEW
This court “review[s] the Commissioner’s decision to determine whether the factual
findings are supported by substantial evidence in the record and whether the correct legal
standards were applied.”14 The Commissioner’s findings, “if supported by substantial evidence,
shall be conclusive.”15 “Substantial evidence is such relevant evidence as a reasonable mind
might accept as adequate to support a conclusion. It requires more than a scintilla, but less than a
preponderance.”16 “In reviewing the ALJ’s decision, [this court may] neither reweigh the
evidence nor substitute [its] judgment for that of the [ALJ].”17 “The failure to apply the correct
8 AR 129-44.
9 AR 55-81.
10 AR 28-54.
11 AR 1-6.
12 42 U.S.C. §§ 405(g), 1383(c)(3); 20 C.F.R. §§ 404.981, 416.1481.
13 ECF No. 1.
14 Lax v. Astrue, 489 F.3d 1080, 1084 (10th Cir. 2007) (citation modified).
15 42 U.S.C. § 405(g).
16 Lax, 489 F.3d at 1084 (citation modified).
17 Madrid v. Barnhart, 447 F.3d 788, 790 (10th Cir. 2006) (citation modified).
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legal standard or to provide this court with a sufficient basis to determine that appropriate legal
principles have been followed [are] grounds for reversal.”18
The aforementioned standards apply to the Commissioner’s five-step evaluation process
for determining whether a claimant is disabled.19 If a determination can be made at any one of
the steps that a claimant is or is not disabled, the subsequent steps need not be analyzed.20
Step one determines whether the claimant is presently engaged in
substantial gainful activity. If [the claimant] is, disability benefits
are denied. If [the claimant] is not, the decision maker must proceed
to step two: determining whether the claimant has a medically
severe impairment or combination of impairments. . . . If the
claimant is unable to show that [her] impairments would have more
than a minimal effect on [her] ability to do basic work activities,
[she] is not eligible for disability benefits. If, on the other hand, the
claimant presents medical evidence and makes the de minimis
showing of medical severity, the decision maker proceeds to step
three.21
At step three, the claimant must show that his or her impairments meet or equal one of
several listed impairments that are “severe enough to prevent an individual from doing any
gainful activity, regardless of his or her age, education, or work experience.”22 “If the
impairment is listed and thus conclusively presumed to be disabling, the claimant is entitled to
benefits. If not, the evaluation proceeds to the fourth step . . . .”23 Before considering step four,
18 Jensen v. Barnhart, 436 F.3d 1163, 1165 (10th Cir. 2005) (citation modified).
19 20 C.F.R. §§ 404.1520(a)(4)(i)-(v), 416.920(a)(4)(i)-(v); see also Williams v. Bowen, 844 F.2d
748, 750-51 (10th Cir. 1988) (discussing the five-step process).
20 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4); see also Williams, 844 F.2d at 750.
21 Williams, 844 F.2d at 750-51 (citation modified); see also 20 C.F.R. §§ 404.1520(a)(4)(i)-(ii),
416.920(a)(4)(i)-(ii).
22 20 C.F.R. §§ 404.1525(a), 416.925(a); see also id. §§ 404.1520(a)(4)(iii), 416.920(a)(4)(iii).
23 Williams, 844 F.2d at 751.
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however, the ALJ must determine the claimant’s residual functional capacity (“RFC”).24 An
individual’s RFC is her greatest ability to do physical and mental work activities on a regular and
continuing basis despite limitations from her impairments.25 In making this determination, the
ALJ must consider all the claimant’s impairments, including impairments that are not severe.26
For the fourth step, the claimant must show, given her RFC, that her impairments prevent
performance of her “past relevant work.”27 “If the claimant is able to perform [her] previous
work, [she] is not disabled.”28 If, however, the claimant is not able to perform her previous work,
she “has met [her] burden of proof, establishing a prima facie case of disability.”29
From here, “[t]he evaluation process . . . proceeds to the fifth and final step,” where the
burden of proof shifts to the Commissioner.30 The decision maker must determine “whether the
claimant has the [RFC] to perform other work in the national economy in view of [her] age,
education, and work experience.”31 If it is determined that the claimant “can make an adjustment
to other work,” she is not disabled.32 If, on the other hand, it is determined that the claimant
“cannot make an adjustment to other work,” she is disabled and entitled to benefits.33
24 20 C.F.R. §§ 404.1520(a)(4), (e), 416.920(a)(4), (e).
25 Id. §§ 404.1545(a)(1), (b)-(c), 416.945(a)(1), (b)-(c).
26 Id. §§ 404.1545(a)(2), (e), 416.945(a)(2), (e).
27 Id. §§ 404.1520(a)(4)(iv), 416.920(a)(4)(iv).
28 Williams, 844 F.2d at 751.
29 Id.
30 Id.
31 Id. (citation modified); see also 20 C.F.R. §§ 404.1520(a)(4)(v), 416.920(a)(4)(v).
32 20 C.F.R. §§ 404.1520(a)(4)(v), 416.920(a)(4)(v).
33 Id. §§ 404.1520(a)(4)(v), 416.920(a)(4)(v).
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ANALYSIS
I. 	The ALJ Adequately Addressed the Supportability and Consistency of the Relevant
Medical Opinions.
Contrary to Plaintiff’s arguments, the RFC is not flawed due to the ALJ’s purported
failure to adequately address the supportability and consistency of the opinions of Dustin G.
Child, M.D. (“Dr. Child”) and Nicole Leonard, M.D. (“Dr. Leonard”). Where, as here, Plaintiff
filed her claims after March 27, 2017, the requirements of 20 C.F.R. §§ 404.1520c and 416.920c
apply to the ALJ’s decision. Paragraph (a) of those sections provides:
When a medical source provides one or more medical opinions or
prior administrative medical findings, we will consider those
medical opinions or prior administrative medical findings from that
medical source together using the factors listed in paragraphs (c)(1)
through (c)(5) of this section, as appropriate. The most important
factors we consider when we evaluate the persuasiveness of medical
opinions 	and 	prior 	administrative 	medical 	findings 	are
supportability (paragraph (c)(1) of this section) and consistency
(paragraph (c)(2) of this section). We will articulate how we
considered the medical opinions and prior administrative medical
findings in your claim according to paragraph (b) of this section.34
Paragraph (b) of 20 C.F.R. §§ 404.1520c and 416.920c require the ALJ to “articulate . . . how
persuasive” the ALJ finds “all of the medical opinions and all of the prior administrative medical
findings in [the claimant’s] case record.”35 And, like paragraph (a), paragraph (b)(2) provides
that “[t]he factors of supportability . . . and consistency . . . are the most important factors we
consider when we determine how persuasive we find a medical source’s medical opinions or
prior administrative medical findings to be.”36 In terms of supportability, paragraph (c)(1)
34 20 C.F.R. §§ 404.1520c(a), 416.920c(a).
35 Id. §§ 404.1520c(b), 416.920c(b).
36 Id. §§ 404.1520c(b)(2), 416.920c(b)(2).
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provides that “[t]he 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.”37 Additionally, paragraph (c)(2) states that “[t]he 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.”38 As shown in order below, the ALJ complied with
these requirements regarding the opinions from Dr. Child and Dr. Leonard.
A. The ALJ Properly Evaluated Dr. Child’s Opinions.
The ALJ soundly considered Dr. Child’s opinions. In the ALJ’s eight-paragraph analysis
of Dr. Child’s opinions, the ALJ clearly explained why Dr. Child’s two opinions from October
2021 and July 2023 were not persuasive.39 Beyond the check-box form of Dr. Child’s opinions,
the ALJ found Dr. Child’s opinions to be unsupported by the treatment regimen he employed for
Plaintiff.40 In other words, if Plaintiff’s condition were as bad as Dr. Child opined in his two
evaluations, his conservative treatment of Plaintiff over time does not support his findings in his
two opinions made specifically for Social Security litigation. The ALJ’s supportability evaluation
of Dr. Child’s opinions complied with the Commissioner’s regulations.
37 Id. §§ 404.1520c(c)(1), 416.920c(c)(1).
38 Id. §§ 404.1520c(c)(2), 416.920c(c)(2).
39 AR 46-47.
40 Id.
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The ALJ then addressed the consistency requirement by finding that Dr. Child’s opinions
relied heavily on Plaintiff’s subjective report of symptoms instead of objective medical
evidence.41 Indeed, a comparison of Dr. Child’s opinion and Plaintiff’s complaints, in the ALJ’s
words, “almost mirror” one another.42 Additionally, the ALJ correctly observed that Dr. Child’s
opinions were inconsistent with those of the state medical consultants, who, after reviewing the
medical evidence, opined that Plaintiff could handle light work.43 Given Dr. Child’s conservative
treatment of Plaintiff over time versus the significant limitations he found specifically for
Plaintiff’s Social Security case, which closely follow Plaintiff’s complaints, coupled with
contrary opinions in the record allowed the ALJ to find that Dr. Child’s observations were as
inconsistent as they were unsupportable. This is all the Commissioner’s regulations required.
Nevertheless, Plaintiff contends that the ALJ’s explanation was legally deficient because
the ALJ did not explain why the state medical consultants’ opinions were better than Dr.
Child’s.44 Although true that the ALJ neither provided a head-to-head comparison of the opinions
of the state medical consultants and Dr. Child nor specifically discussed why one doctor’s
opinion was more persuasive than the other, the ALJ clearly stated why he found the opinions of
the state medical consultants persuasive.45 The ALJ observed that those medical consultants
reviewed the medical records and made recommendations that were supported by and internally
41 AR 47.
42 Id. (citing AR 589-95, 603).
43 AR 45, 47.
44 ECF No. 13 at 22; ECF No. 18 at 4.
45 AR 45, 47.
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consistent with the “objective medical evidence,” including imaging of the lumbar spine.46 Thus,
the ALJ more than adequately explained why he found persuasive the state medical consultants’
opinions and why Dr. Child’s opinions were not persuasive.
More fundamentally, however, Plaintiff’s argument that the ALJ should have engaged in
a head-to-head comparison of doctors is legally flawed. Plaintiff cites to no legal authority from
any source requiring an ALJ to engage in such a comparison, and the court cannot find such
authority. Moreover, Plaintiff fails to understand that this court’s review “must be based on the
record taken as a whole.”47 In other words, the center of the court’s analysis is whether the ALJ’s
finding that Plaintiff is not disabled is supported by substantial evidence considering the entire
record. The focal point of judicial review is not Dr. Child’s opinions. Put another way, there is no
legal requirement for the ALJ to explain how he specifically compared and contrasted Dr. Child’s
medical opinions against all challengers and why the challengers’ views triumphed over Dr.
Child’s. That is not how appellate review works. The fact is the ALJ more than adequately
discussed the supportability and consistency of both Dr. Child’s opinions and those of the state
medical consultants and believed that the state medical consultants were entitled to greater
weight in rendering an RFC determination. The ALJ’s weighing of contradictory expert opinion
is something this court will not redo. Therefore, the ALJ’s discussion of Dr. Child’s opinions
complied with relevant law.
46 AR 45.
47 Wall v. Astrue, 561 F.3d 1048, 1052 (10th Cir. 2009) (citation modified).
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B. The ALJ Also Properly Evaluated Dr. Leonard’s Opinions.
Plaintiff’s arguments regarding Dr. Leonard fare no better than her arguments regarding
Dr. Child. The ALJ’s three-paragraph discussion of Dr. Leonard’s opinions also met the
regulatory requirements for consistency and supportability.48 The ALJ observed that Dr.
Leonard’s finding that Plaintiff “would not be prevented from lifting and carrying light
objects . . . is not inconsistent with a restriction to light exertion.”49 The ALJ found this opinion
from Dr. Leonard to be consistent with Dr. Leonard’s findings from her objective examination of
Plaintiff, supported by other medical evidence in the record, and consistent with the RFC.50
However, the ALJ rejected Dr. Leonard’s “postural and stand/walk limitations” because the ALJ
found the state medical consultants’ opinions to be more persuasive,51 which the court discussed
above. The ALJ had conflicting medical opinions, considered them both, and found one more
persuasive than the other. The court will not reweigh the evidence or require the ALJ to place
medical providers favorable to Plaintiff’s position as the center of attention against which all
other medical opinion must be measured. All the regulations require is a discussion of how
persuasive an opinion is through the lens of supportability and consistency. The ALJ complied
with those requirements. Thus, Plaintiffs’ challenge to how the ALJ weighed Dr. Leonard’s
opinions fails.
48 AR 46.
49 Id.
50 Id.
51 Id.
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II. 	The ALJ Did Not Err in Refusing to Place Mental Limitations in the RFC.
The ALJ’s RFC assessment is supported by substantial evidence even though it lacks
mental limitations. “A claimant must make only a de minimis showing to advance beyond step
two [in the five-step inquiry]. To that end, a claimant need only establish, and an ALJ need only
find, one severe impairment.”52 Indeed, the applicable regulations “require[] a claimant to show
only “a severe” impairment—that is, one severe impairment—to avoid a denial of benefits at
step two.”53 And “[a]s long as the ALJ finds one severe impairment, the ALJ . . . must proceed to
the next step. Thus, the failure to find a particular impairment severe at step two is not reversible
error when the ALJ find that at least one other impairment is severe.”54
The ALJ did not find that Plaintiff’s mental health impairments were “severe” at step
two.55 But the ALJ found other severe impairments, which caused further analysis under
subsequent steps in the five-step adjudicative process.56 Thus, the ALJ’s failure to find severe
mental health impairments at step two is of no moment here.
Nevertheless, the ALJ must consider even non-severe impairments when formulating the
RFC.57 Here, the ALJ did. Aside from the ALJ’s discussion in his analysis of step two, the ALJ
engaged in additional analysis in step four as to why he found the opinions of Plaintiff’s mental
52 Allman v. Colvin, 813 F.3d 1326, 1330 (10th Cir. 2016) (citation modified).
53 Id. (emphasis in original).
54 Id.
55 AR 34.
56 Id.
57 20 C.F.R. §§ 404.1545(a)(2), (e), 416.945(a)(2), (e); Allman, 813 F.3d at 1330 (stating that the
“ALJ must consider the limiting effects of non-severe impairments in determining the claimant’s
RFC”).
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health providers were not persuasive.58 Specifically, the ALJ noted that the mental health
opinions by Plaintiff’s providers were only partially persuasive because their opinions “are not
supported by current examinations of the claimant or reviews of the current medical record.”59 In
fact, the ALJ stated that their opinions were “from a previously adjudicated period of disability”
that was dated “almost four and a half years prior to the alleged onset date and [were] remote in
time.”60
Additionally, the court cannot ignore the fact that the mental health examiners reached
differing conclusions about the extent of Plaintiff’s mental health impairments. One examiner
found Plaintiff’s mental disorders “Non Severe”61 while another found them “Severe.”62 The
ALJ also observed that Plaintiff’s depression was well controlled with medication and that no
provider recommended that she “seek treatment by a psychiatrist, a psychologist, or a mental
health counselor or therapist.”63 The ALJ pointed to medical records showing that Plaintiff was
alert and maintained appropriate eye contact, speech, mood, and affect during her medical
examinations along with normal levels of judgment, memory, and concentration.64 Plaintiff
denied having panic attacks, “hallucinations, delusions, paranoid ideation, odd or unusual beliefs,
58 AR 47.
59 Id.
60 Id.
61 AR 86.
62 AR 94, 107.
63 AR 35.
64 AR 35-36.
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and other psychotic processes.”65 The ALJ further noted that Plaintiff’s test scores suggested a
“Mild Cognitive Impairment” and that “her level of intelligence [was] within the average
range.”66 The ALJ also noted that Kent H. Gregory, Psy.D., diagnosed Plaintiff with major
depressive disorder and anxiety disorder but that the “largely unremarkable findings from the
psychological consultative examination do not support allegations of a severe mental health
impairment.”67 All of this shows that the ALJ thoroughly examined the record and assessed the
conflicting evidence regarding Plaintiff’s mental health impairments. How the ALJ weighed this
evidence is something with which Plaintiff disagrees, but it is not something this court will redo.
Thus, even if the ALJ should have found Plaintiff’s mental health impairments “severe” at step
two, the ALJ’s thorough decision not to include any limitations in the RFC at step four is
supported by substantial evidence.
O RDER
For the reasons stated above, the Commissioner’s decision is AFFIRMED.
IT IS SO ORDERED.
DATED this 10th day of December 2025.
BY THE COURT:
JARED C. BENNETT
United States Magistrate Judge
65 AR 35.
66 Id.
67 AR 36.
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