Case Name in Social Security Case - Unavailable

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF LOUISIANA
A.B. 	CIVIL ACTION
VERSUS 	NO. 24-2384
FRANK BISIGNANO,
COMMISSIONER OF
SOCIAL SECURITY
SECTION: “J” (3)
REPORT AND RECOMMENDATION
Plaintiff 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 Plaintiff asks the Court to reverse the Administrative Law
Judge’s (“ALJ”) holding that Plaintiff 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. 15.
3 Id. at 9.
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. 16 at 12.
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considered the parties’ briefing and the administrative record6 in the light of the
applicable law, it is recommended that Plaintiff’s appeal be denied.
I. 	Background
Plaintiff is a 52-year-old female.7 She has a college degree and work experience
as a registered nurse.8 Plaintiff applied for disability insurance benefits on June 12,
2023.9 In her application documents, Plaintiff represented that she suffered from
arthritis, plantar fasciitis, bipolar, depression, ADHD, anxiety, and PTSD, and was
rendered disabled by these conditions on April 5, 2021.10 After the Administration
denied her application and request for reconsideration,11 a hearing to review the
claim was held at Plaintiff’s request.12 The ALJ issued a decision on May 16, 2024,
holding that Plaintiff was not disabled within the definition of the SSA13 between
April 5, 2021, the amended alleged onset date, through September 30, 2022, the date
last insured.14
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:
6 R. Doc. 9.
7 Id. at 69.
8 Id. at 47.
9 Id. at 203.
10 Id. at 289, 342. Plaintiff amended her alleged onset date from July 31, 2017, to
April 5, 2021. Id.
11 Id. at 91, 103.
12 Id. at 17–28.
13 See 42 U.S.C. §§ 416(i), 423(d).
14 R. Doc. 9 at 27–28.
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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 Plaintiff satisfied steps one and two. First, Plaintiff had
not engaged in substantial gainful activity since the alleged onset date of her
disability.15 Second, the ALJ found that Plaintiff suffered from severe impairments
including “anxiety disorder, bipolar disorder, posttraumatic stress disorder (PTSD),
attention deficit hyperactivity disorder (ADHD), and substance use disorder (20 CFR
404.1520(c).”16 The ALJ determined that Plaintiff did not satisfy step three, however,
because none of these impairments or any combination thereof met or equaled an
impairment listed in Appendix One.17 At step four, the ALJ found that Plaintiff had
15 Id. at 20.
16 Id.
17 Id. at 20–21.
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the residual functional capacity to perform a full range of work with limitations18 and
was therefore capable of adjusting to other work that existed in significant numbers
in the national economy.19 Therefore, the ALJ found that Plaintiff was not disabled
from April 5, 2021, the amended alleged onset date, through September 30, 2022, the
date last insured.20
Plaintiff asserts that the ALJ erred at step three by failing to conduct an
analysis of whether Plaintiff medically equaled Listings 12.04, 12.06, 12.08, 12.11, or
12.15.21
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
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]
18 Id. at 22.
19 Id. at 26.
20 Id. at 27.
21 R. Doc. 15 at 1–2.
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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
A. 	Plaintiff has not shown that the ALJ erred at Step Three.
At Step Three, claimants must show that they meet or equal a listing. Plaintiff
does not dispute the ALJ’s conclusion that she does not meet any listing. Plaintiff
attacks only the ALJ’s analysis as to whether she medically equals a listing.
If claimants cannot show they “meet” all the criteria in the listing, they may
still seek to prove that they “medically equal[]” a listing, rendering 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)).
Medical equivalence is not a means by which a claimant may be found
disabled simply by getting close to meeting a Listing; meeting 5 out of 6
criteria does not suddenly become good enough to find a claimant
disabled. When a claimant fails to meet all the criteria of a Listing, that
gap 	cannot 	just 	be 	ignored. 	Instead, 	the 	claimant 	must 	point 	to
something to fill that gap, whether it is some other finding of equal
medical significance, see 20 C.F.R. § 404.1526(b)(1)(ii), or a combination
of impairments, see 20 C.F.R. § 404.1526(b)(3).
Cueller v. Astrue, No. 10-C-619, 2011 WL 1743841, at *5 (E.D. Wis. May 5, 2011). On
appeal, Plaintiff does not cite or discuss any evidence that would support a finding of
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medical equivalence. Instead, she relies on an allegation that the ALJ provided an
insufficient explanation at step three. This argument is unavailing.
1. 	Plaintiff 	has 	identified 	no 	evidence 	contrary 	to 	the 	ALJ’s
conclusion that the “B criteria” findings did not medically equal a
listing under 20 C.F.R. § 404.1526(b)(1)(B).
Plaintiff relies on 20 C.F.R. § 404.1526(b)(1)(B) to show medical equivalence.22
That provision instructs that the SSA may find medical equivalence when a claimant
“exhibit[s] all of the findings [of a particular listing from appendix 1], but one or more
of the findings is not as severe as specified in the particular listing.”
The ALJ identified the following listings in Appendix 1 as potential medical
equivalents: depressive, bipolar and related disorders (12.04); anxiety and obsessive-
compulsive disorders (12.06); personality and impulse-control disorders (12.08);
neurodevelopmental disorders (12.11); and trauma- and stressor-related disorders
(12.15).23 In conjunction with a full analysis of the record, the ALJ concluded that
“[t]he severity of the claimant’s mental impairments, considered singly and in
combination, did not meet or medically equal the criteria of listings 12.04, 12.06,
12.08, 12.11, and 12.15.”24
With regards to the “paragraph B” criteria for listings 12.04, 12.06, 12.08 and
12.11,25 the ALJ found that Plaintiff exhibited only “moderate” limitations in all four
22 R. Doc. 15 at 4. Plaintiff’s argument centered on § 404.1526(b)(1)(B). Plaintiff did
not present any argument as to § 404.1526(b)(3), but any such argument would not
change the analysis.
23 R. Doc. 9 at 20; 20 C.F.R. § Pt. 404, Subpt. P, App. 1., § 12.00.
24 R. Doc. 9 at 20.
25 For Listings 12.04, 12.06, and 12.15, if a claimant does not satisfy “paragraph B”
criteria, she may alternatively qualify for medical equivalency through satisfaction
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mental functioning areas.26 First, the ALJ determined that Plaintiff had only a
“moderate”27 limitation in understanding, remembering, and applying information.28
The ALJ referenced a January 31, 2022 treatment note that stated Plaintiff was able
remember three words immediately after learning them and also after a delay of five
minutes, 	to 	perform 	simple 	arithmetic, 	and 	correctly 	answer 	general 	fund 	of
information questions.29 The psychiatric evaluation appeared to be in connection with
Plaintiff’s history of anxiety, depression, bipolar disorder and ADHD.30 The ALJ also
relied on a 2022 evaluation that Plaintiff’s memory was intact in a visit that
addressed Plaintiff’s complaints of anxiety, trauma, ADHD and mania.31
Next, the ALJ found that Plaintiff had a “moderate” limitation in interacting
with others.32 The ALJ evaluated Plaintiff’s report that she did not feel comfortable
around other people or crowds33 as well as her testimony that she felt anxious around
of “paragraph C” criteria. 20 C.F.R. § Pt. 404, Subpt. P, App. 1, §12.00(A)(2). Plaintiff
does not maintain that she qualified for medical equivalency through “paragraph C”
criteria, and the record shows that she did not meet those criteria.
26 R. Doc. 9 at 20–21; see 20 C.F.R. § 404.1526(b)(1); see DI 24583.010 Determining
Medical Equivalence for Mental Impairments, SSA POMS DI 24583.010 (“In many
cases involving multiple mental impairments, it is not possible to identify which
mental impairment causes the functional limitations that satisfy the paragraph B
criteria.”).
27 Plaintiff has “moderate” functioning if her functioning in an area independently,
appropriately, effectively, and on a sustained basis is fair. 20 C.F.R. § Pt. 404, Subpt.
P, App. 1, § 12.00(F)(2).
28 R. Doc. 9 at 20.
29 Id. (citing R. Doc. 9 at 410).
30 Id. at 401–405.
31 Id. at 20 (citing R. Doc. 9 at 513–14).
32 Id.
33 Id. (citing R. Doc. 9 at 401).
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other people, had anger outbursts, and had gotten into fights.34 The ALJ also
considered a 2021 treatment note regarding Plaintiff’s anxiety, depression, daily
functioning, ADHD, drug use and mania that stated that Plaintiff presented as calm,
cooperative, happy, and appeared friendly.35
The ALJ also found a “moderate” limitation functioning in the area of
concentrating, persisting or maintain pace.36 The ALJ discussed a treatment note
reporting that Plaintiff was able to sufficiently spell the word “world” backwards,37
two notes reporting that Plaintiff had no attention difficulties,38 as well as Plaintiff’s
report that she did not have any inattentiveness, or disorganization.39 The ALJ also
considered the Plaintiff’s report that she had a short attention span, could not keep
focused, and had difficulty paying attention and staying on task.40 The evaluations
were relative to Plaintiff’s anxiety, depression, bipolar disorder, ADHD, mania, and
Plaintiff’s history of substance abuse, trauma, and assaulting others.41
Finally, the ALJ concluded that Plaintiff had a moderate limitation for
adapting or managing oneself.42 The ALJ considered two separate medical notes
34 Id. at 404, 453, 455.
35 Id. at 21 (citing R. Doc. 9 at 415); id. at 414.
36 Id. at 20–21.
37 Id.at 21, 410.
38 Id. at 21, 480, 496.
39 Id. (citing R. Doc. 9 at 414). The ALJ’s summary of Plaintiff’s report is not fully
supported by the record. Plaintiff reported that she had “[i]mprovement in symptoms
of inattention [] at work and at home” and denied “problems in daily functioning and
is able to go to work.” Id. at 414. The discrepancy does not affect the Court’s overall
conclusion that the ALJ’s decision was supported by substantial evidence.
40 Id. (citing R. Doc. 9 at 402).
41 Id. at 401–405, 411, 475–77, 490–92.
42 Id. at 21.
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reporting that Plaintiff’s judgement and insight were fair43 and a treatment note that
Plaintiff was well groomed.44 Additionally, the ALJ discussed Plaintiff’s report that
she could dress and bathe herself, perform household chores, cook for herself,
complete errands, and shop.45 The treatment notes were relative to Plaintiff’s
depression, anxiety, bipolar disorder, ADHD, PTSD, substance abuse, and history of
assaulting others.46
After finding that Plaintiff had only “moderate” limitations, rather than the
requisite 	“extreme” 	or 	“marked” 	limitations 	for 	medical 	equivalency, 	the 	ALJ
properly concluded that Plaintiff did not satisfy “paragraph B” criteria.47 Plaintiff
does not challenge this finding.
The ALJ further concluded that Plaintiff also did not demonstrate medical
equivalency.48 In doing so, she noted that this step-3 conclusion is distinct from the
step-4 residual functional capacity assessment.49 The ALJ clarified, however, that the
step-4 residual functional capacity assessment provided a “more detailed assessment
of the areas of functioning” and “reflects the degree of limitation the undersigned has
found in the [step-3] “paragraph B” mental function analysis.”50 The step-4 analysis
relative to residual functioning makes clear that the ALJ fully considered the
43 Id. at 21, 480, 496.
44 Id. at 21, 410.
45 Id. at 21 (citing R. Doc. 9 at 405).
46 Id. at 401–05, 411.
47 Id. at 21; see 20 C.F.R. § Pt. 404, Subpt. P, App. 1.
48 R. Doc. 9 at 21.
49 Id.
50 Id.
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cumulative effects of Plaintiff’s limitations when assessing whether they were
medically equivalent to a listing.51
Plaintiff disagrees with the ALJ’s conclusion, but she does not point to evidence
to support her disagreement. Plaintiff notes that the ALJ assessed “moderate global
delays in all 4 of the B criteria of FIVE separate Listings.”52 Plaintiff then poses the
rhetorical question: “If a claimant would meet ONE listing based on a single diagnosis
which resulted in marked limitations in 2 of the B criteria but none in the others,
then why wouldn’t [Plaintiff] equal the Listing(s) with five diagnoses implicating
FIVE listings with moderate global impairments?”53 There is no algebraic recitation,
however, by which an ALJ must conclude that a certain number of moderate
impairments is the medical equivalent of a marked impairment. 	And, as explained
above, the ALJ provided a thorough and substantive explanation for the conclusion
that 	Plaintiff’s 	impairment 	did 	not 	medically 	equal 	a 	listing 	under 	§
404.1526(b)(1)(B).
2. 	The ALJ provided an adequate explanation for the conclusion that
Plaintiff did not medically equal a listing.
Plaintiff argues that the ALJ’s explanation was inadequate under Audler v.
Astrue, 501 F.3d 446, 448 (5th Cir. 2007). By the express terms of 42 U.S.C.
§405(b)(1), the ALJ is required to discuss the evidence in support of Plaintiff’s claim
for disability and to explain why she found that Plaintiff was not disabled at that
51 See id. at 22–26–.
52 R. Doc. 15 at 4.
53 Id. at 4.
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step. 42 U.S.C. §405(b)(1). In Audler, 501 F.3d at 448, the Fifth Circuit concluded that
an ALJ’s step-3 explanation was insufficient. But there, the ALJ did not identify the
listed impairment(s) at issue. Here, the ALJ identified and discussed the listings at
issue (12.04, 12.06, 12.08, 12.11, and 12.15).54 And in Audler, the ALJ did not explain
why the claimant’s symptoms were insufficiently severe to meet a listed impairment.
See 501 F.3d at 448. Here, the ALJ provided an explanation relative to the conclusion
that the Plaintiff did not meet or equal a listing. In short, Audler involved an instance
in which an ALJ “offered nothing to support her conclusion at this step” such that she
failed to meet the statutory requirement to provide an explanation. Id. The ALJ’s
explanation in this case was detailed and in-line with the explanations held sufficient
in other cases. See Belk v. Colvin, 648 F. App’x 452, 454 (5th Cir. 2016); Russo v. Saul,
805 F. App’x 269, 273–74 (5th Cir. 2020).
“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). The Fifth Circuit reaffirmed this principle in Audler: “Having
determined that the ALJ erred in failing to state any reason for her adverse
determination at step 3, we must still determine whether this error was harmless.”
Audler, 501 F.3d at 448. 	Thus, even if a claimant establishes that an ALJ’s
explanation is deficient, the claimant still bears the burden of demonstrating that the
error affected her substantial rights. See id.
54 See, e.g., R. Doc. 9 at 20.
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Unlike in Audler, Plaintiff has not described the evidence that purportedly
supports a finding that she meets or medically equals a listing. See id. at 448 (citing
evidence and concluding that the plaintiff appeared to have met her burden). The
closest that Plaintiff comes is two paragraphs in her statement of facts. The first
paragraph states that Plaintiff has a well-documented “history of social aversion”;
“isolates herself from others and avoids public places”; and “frequently avoid[s] social
situations despite taking medication.55 The second paragraph states that Plaintiff
exhibited symptoms 	including 	“pressured speech,” 	“racing 	thoughts 	daily” and
“psychomotor agitation.”56 In noting these points, Plaintiff places particular reliance
on the progress notes of Nurse Practitioner Menendez.
The ALJ, however, specifically reviewed NP Menendez’s progress notes and
found his opinion “generally persuasive.”57 As noted above, the ALJ recognized that
Plaintiff demonstrated moderate impairments in the paragraph B criteria, including
because of discomfort around others and in crowds and because of her a moderate
limitation in concentrating, persisting, or maintaining pace.58 The ALJ did not
conclude, however, that any of these impairments were “marked” (i.e., “seriously
limited the ability to function independently, appropriately, or effectively, and on a
sustained basis”). 	And Plaintiff 	has 	provided no 	evidentiary 	support 	for her
disagreement with the ALJ’s determination as to medical equivalence.
55 R. Doc. 15 at 2 (citing R. Doc. 9 at 486, 506, 502).
56 Id. at 3 (citing R. Doc. 9 at 524, 566, 570, 574).
57 R. Docs. 9 at 25, 16 at 9.
58 R. Doc. 9 at 20–21.
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B. 	This 	case 	does 	not 	implicate 	Plaintiff’s 	challenge 	to 	Social
Security Ruling 17-2p.
Finally, Plaintiff argues that Social Security Ruling 17-2p contradicts 20
C.F.R. § 404.1526(e)(3) and fails under Loper Bright Enterprises. v. Raimondo, 603
U.S. 369 (2024). See Soc. Sec. Ruling 17-2p; Titles II & XVI: Evidence Needed by
Adjudicators at the Hearings and Appeals Council Levels of the Administrative
Review Process to Make Findings about Medical Equivalence. (S.S.A. Mar. 27, 2017)
(“SSR 17-2p”). The ALJ neither cited nor relied on Ruling 17-2. Further,Plaintiff’s
argument as to Rule 17-2p is untethered from the facts of the instant case.
Plaintiff suggests that SSA’s interpretation of Social Security Ruling 17-2p
allows an ALJ to skip the step 3 analysis altogether. Yet, as explained above, the ALJ
did not do so here. Plaintiff further suggests that the SSA’s interpretation allows an
ALJ to use the steps 4-5 analysis interchangeably with step 3. 	Here, however, the
ALJ expressly acknowledged that each step involved a different analysis and did not
conflate the two analyses.59 Plaintiff also suggests (at least in her opening brief) that
Social Security Ruling 17-2p allows an ALJ to transfer his or her authority to a
medical expert.60 As reflected by Plaintiff’s reply, however, the ALJ in this case
“rejected the agency experts’ findings, as she assessed a greater degree of limitations
in two of the four ‘paragraph B’ criteria” than the agency medical experts found.61 In
doing so, the ALJ made clear that she did not “defer or give any specific evidentiary
59 The ALJ’s reference to facts discussed in a later step does not suggest any confusion
as to the appropriate legal inquiry for each step.
60 R. Doc. 15 at 5–9.
61 R. Doc. 20 at 3.
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weight, including controlling weight,” to any prior administrative medical finding(s)
or medical opinion(s), including those from medical sources.62 	Thus, there was no
abrogation of responsibility.
III. 	Recommendation
For the foregoing reasons,
IT IS RECOMMENDED that the decision of the Administrative Law Judge
be AFFIRMED.
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
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 6 th day of November, 2025.
__________________________________________
EVA J. DOSSIER
UNITED STATES MAGISTRATE JUDGE
62 R. Doc. 9 at 25.
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