McAfee v. Commissioner of Social Security Administration et al

IN THE UNITED STATES DISTRICT COURT FOR THE
WESTERN DISTRICT OF OKLAHOMA
A.M.M., )
)
Plaintiff, )
)
v. ) Case No. CIV-24-1318-STE
)
FRANK BISIGNANO, )
Commissioner of the Social Security )
Administration, )
)
Defendant. )
MEMORANDUM OPINION AND ORDER
Plaintiff brings this action pursuant to 42 U.S.C. § 405(g) for judicial review of the
final decision of the Commissioner of the Social Security Administration denying Plaintiff’s
application for disability insurance benefits under the Social Security Act. The
Commissioner has answered and filed a transcript of the administrative record
(hereinafter TR. ____). The parties have consented to jurisdiction over this matter by a
United States magistrate judge pursuant to 28 U.S.C. § 636(c).
The parties have briefed their positions, and the matter is now at issue. Based on
the Court’s review of the record and the issues presented, the Court REVERSES AND
REMANDS the Commissioner’s decision.
I. PROCEDURAL BACKGROUND
Initially and on reconsideration, the Social Security Administration denied Plaintiff’s
application for benefits. Following an administrative hearing, an Administrative Law Judge
(ALJ) issued an unfavorable decision. (TR. 14-29). The Appeals Council denied Plaintiff’s
request for review. (TR. 1-3). Thus, the decision of the ALJ became the final decision of
the Commissioner.
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II. THE ADMINISTRATIVE DECISION
The ALJ followed the five-step sequential evaluation process required by agency
regulations.
See Fischer-Ross v. Barnhart, 431 F.3d 729, 731 (10th Cir. 2005); 20 C.F.R.
§ 404.1520. At step one, the ALJ determined that Plaintiff had not engaged in substantial
gainful activity since May 7, 2021, the amended alleged disability onset date. (TR. 17).
At step two, the ALJ determined Plaintiff suffered from severe: major depressive disorder;
generalized anxiety disorder; anorexia nervosa; and PTSD (TR. 17). At step three, the
ALJ found that Plaintiff’s impairments did not meet or medically equal any of the
presumptively disabling impairments listed at 20 C.F.R. Part 404, Subpart P, Appendix 1
(TR. 17).
At step four, the ALJ concluded that Plaintiff retained the residual functional
capacity (RFC) to:
[P]erform a full range of work at all exertional levels but with the following
nonexertional limitations: She can understand, remember, and apply
simple, multistep instructions, make simple work-related decisions, and
concentrate and persist for extended periods in order to complete simple,
multistep work tasks with routine supervision. She can interact with and
respond appropriately to others in a routine work setting, incidental to the
work being performed. However, she would need to avoid workrelated
interaction with the general public. She can adapt to a routine work setting
where changes are infrequent, well-explained, and introduced gradually.
She can recognize and avoid normal workplace hazards.
(TR. 20).
With these limitations, the ALJ concluded that Plaintiff was unable to perform any
past relevant work. (TR. 27). As a result, the ALJ presented the RFC to a vocational expert
(VE) to determine whether there were other jobs in the national economy that Plaintiff
could perform. (TR. 58). Given the limitations, the VE identified three jobs from the
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Dictionary of Occupational Titles that Plaintiff could perform. (TR. 59). The ALJ then
adopted the VE’s testimony and concluded, at step five, that Plaintiff was not disabled
based on her ability to perform the identified jobs. (TR. 29).
III. ISSUE PRESENTED
On appeal, Plaintiff alleges error in the ALJ’s failure to: (1) properly evaluate
medical opinions from licensed professional counselor, Alison Squire; (2) account for all
relevant evidence when determining Plaintiff’s mental RFC; and (3) properly evaluate
Plaintiff’s subjective statements. (ECF No. 12:4-15, 21:2-11).
IV. STANDARD OF REVIEW
This Court reviews the Commissioner’s final decision “to determin[e] whether the
Commissioner applied the correct legal standards and whether the agency’s factual
findings are supported by substantial evidence.”
Noreja v. Commissioner, SSA, 952 F.3d.
1172, 1177 (10th Cir. 2020) (citation omitted). Under the “substantial evidence” standard,
a court looks to an existing administrative record and asks whether it contains “sufficien[t]
evidence” to support the agency’s factual determinations.
Biestek v. Berryhill, 139 S. Ct.
1148, 1154 (2019). “Substantial evidence . . . is more than a mere scintilla . . . and means
only—such relevant evidence as a reasonable mind might accept as adequate to support
a conclusion.”
Biestek v. Berryhill, 139 S. Ct. at 1154 (internal citations and quotation
marks omitted).
While the court considers whether the ALJ followed the applicable rules of law in
weighing particular types of evidence in disability cases, the court will “neither reweigh
the evidence nor substitute [its] judgment for that of the agency.”
Vigil v. Colvin, 805
F.3d 1199, 1201 (10th Cir. 2015) (internal quotation marks omitted).
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V. ERROR IN THE ALJ’S EVALUATION OF MS. SQUIRE’S OPINION
Plaintiff alleges legal error in the ALJ’s evaluation of a medical opinion from
Plaintiff’s licensed professional counselor, Alison Squire. (ECF No. 12:4-10). The Court
agrees.
A. Ms. Squire’s Opinion and the ALJ’s Related Evaluation
On January 18, 2024, Ms. Squire, who had who had treated Plaintiff from 2021-
2024, authored a Medical Statement of Ability to do Work-Related Activities (Mental)
regarding Plaintiff’s mental health and limitations.
See TR. 3268-3270. In the statement,
Ms. Squire stated that Plaintiff currently met the criteria for diagnoses of Anorexia
Nervosa, Generalized Anxiety Disorder and Major Depressive Disorder. (TR. 3269). Ms.
Squire then opined that Plaintiff was “markedly” limited in her abilities to: (1) make
judgments on complex work-related decisions and (2) respond appropriately to usual
work situations and to changes in a routine work setting. (TR. 3268-3269). Ms. Squire
provided the following explanation in support of her first opinion:
Due to [Plaintiff’s] ongoing diagnoses[,] areas such as concentration have
been impacted. Her ability to focus, concentrate, and follow through with
some tasks have been impaired. She becomes overwhelmed, experiences
panic attacks, and challenging intrusive thoughts.
(TR. 3268).
In support of her second opinion, Ms. Squire stated:
[Plaintiff] becomes overwhelmed in social situations as well as interactions
with acquaintances and those she does not know. Additionally, [Plaintiff’s]
ability to adjust to unexpected changes and challenges are impacted.
(TR. 3269).
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The ALJ acknowledged the opinions, but rejected them as unpersuasive as “lacking
in support . . . [as] not reflected in her medical records” and “inconsistent with other
evidence in the record.” (TR. 25).
B. The ALJ’s Duty to Evaluate Medical Opinions
The Social Security regulations define a “medical opinion” as “a statement from a
medical source about what [a claimant] can still do despite [her] impairment(s) and
whether [a claimant] ha[s] one or more impairment-related limitations or restrictions” in
her abilities to:
• Perform physical demands of work activities;
• Perform mental demands of work activities;
• Perform other demands of work, such as seeing, hearing, or using other
senses; and
• Adapt to environmental conditions, such as temperature extremes or
fumes.
20 C.F.R. § 404.1513(a)(2). Regardless of its source, the ALJ has a duty to evaluate every
medical opinion in the record.
See 20 C.F.R. §§ 404.1513a(b)(2), 404.1520c. In doing so,
the ALJ need only articulate how persuasive he finds the medical opinion. 20 C.F.R.
§ 404.1520c(b). Persuasiveness is determined primarily by an opinion’s supportability and
consistency, and the ALJ must explain how he considered those factors. 20 C.F.R. §
404.1520c(b)(2) & (c)(1)-(2). “Supportability” refers to the ALJ examining the medical
source’s own medical evidence and supporting explanations to determine whether the
source’s opinions (based on the evidence) are persuasive. 20 C.F.R. § 404.1520c(c)(1).
“Consistency” involves comparing the medical source’s opinion with other medical
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evidence and prior administrative finding to see whether the opinions and evidence are
consistent. 20 C.F.R. § 404.1520c(c)(2).
In addition, the ALJ may, but is not required to, discuss other considerations that
may bear on the persuasiveness of a medical opinion, such as the relationship of the
source to the claimant, the source’s area of specialization, and other factors such as the
source’s familiarity with the disability program’s policies and evidentiary requirements.
See 20 C.F.R. § 404.1520c(c)(3)-(5). Finally, the ALJ’s rationale must be “sufficiently
specific” to permit meaningful appellate review1 and supported by substantial evidence.2
C. Error in the ALJ’s Evaluation of Ms. Squire’s Opinion
In evaluating Ms. Squire’s opinions, the ALJ addressed the factors of consistency
and supportability, as required by the regulations.
See supra,
see TR. 25-26. But the
Court finds neither explanation supported by substantial evidence.
1. The “Consistency” Factor
The Court first finds error in the ALJ’s evaluation of Ms. Squire’s opinion as
consistent with her own internal records. As stated, “consistency” involves comparing the
medical source’s opinion with other medical evidence and prior administrative findings to
see whether the opinions and evidence are consistent. 20 C.F.R. § 404.1520c(c)(2). Here,
the ALJ found that Ms. Squire’s opinions were “inconsistent with other evidence in the
record.” (TR. 26). Yet, in support of this “rejection” the ALJ noted that Plaintiff had
1
See Oldham v. Astrue, 509 F.3d 1254, 1258 (10th Cir. 2007).
2
Langley v. Barnhart, 373 F.3d 1116, 1121 (10th Cir. 2004).
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reported “overwhelm[ing] and intrusive thoughts in records from the Eating Recovery
Centers records from August 17 through October 9, 2021.” (TR. 27). Indeed, records
from the Eating Recovery Centers noted Plaintiff suffered from:
• anxiety and intrusive thoughts;
• self-deprecating thoughts;
• “daily passive suicidal ideation;”
• self-harming behaviors, sometimes daily, including cutting (over 100 times),
burning herself (over 50 times), hitting herself (maybe 10 times),
purposefully banged her head (multiple times), purposefully driving
recklessly (about 50 times), and attempted hanging herself;
• poor concentration;
• inattentiveness;
• panic attacks “daily for the last few months;”
• poor memory;
• distractibility in memory and attention;
• a preoccupation in thoughts with eating disorder behaviors;
• cognitive distortions; and
• moderate to severe levels of obsessive thinking.
(TR. 449, 452, 455, 457, 464, 479, 488, 489, 494, 497, 498, 501, 505, 509, 791, 795,
804, 806, 810, 825). This recitation of the records from the Eating Recovery Centers is
by no means exhaustive as the records are quite extensive. Even so, the records noted
are clearly consistent with Ms. Squire’s opinions that Plaintiff suffered from an impaired
ability to concentrate and focus, as well as becoming overwhelmed and experiencing
panic attacks, and challenging intrusive thoughts.
See supra. The Court specifically notes
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that although the ALJ found that Plaintiff “complained of panic attacks on only five
occasions, not an ongoing basis,” the record suggests otherwise, as Plaintiff reported at
one point suffering “daily” panic attacks for “a few months.”
See TR. 458.
Again, although facially, the ALJ provided rationales in support of rejecting Ms.
Squire’s opinions as not consistent with the other evidence of record, a review of those
records suggest otherwise and on this basis remand is warranted.	
See Langley v.
Barnhart, 373 F.3d 1116, 1121 (10th Cir. 2004) (reversal warranted, in part, because the
ALJ’s reasons for completely rejecting a medical opinion were not supported by
substantial evidence).
2. The Supportability Factor
The Court also finds error in the ALJ’s “supportability” analysis when evaluating
Ms. Squire’s opinion. Regarding this factor, i.e., whether Ms. Squire’s records supported
her findings concerning Plaintiff’s “marked” limitations, the ALJ cited:
• A May 18, 2023 report from Plaintiff regarding “pacing herself in getting things
done;”
• A June 13, 2023 report from Plaintiff that she was “able to get a few things done
around the house;” and
• Notations from September 21 and 29, 2023 stating that Plaintiff “referenced things
that she felt like she needed to get [d]one before her son’s delivery.”
(TR. 26). Presumably, the ALJ relied on Plaintiff’s reports of “getting things done” as a
basis to find that Ms. Squire’s records did not support her findings that Plaintiff’s ability
to “follow through with some tasks have been impaired.” But the ALJ’s rationales address
only a portion of Ms. Squire’s opinion—Plaintiff’s ability to follow through with some tasks.
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Regarding the remaining pieces of Ms. Squire’s opinion—that Plaintiff becomes
overwhelmed in social situations and experiences panic attacks and challenging intrusive
thoughts—the ALJ acknowledged three instances wherein Plaintiff reported being
“overwhelmed” and one time when Plaintiff reported having “intrusive thoughts.” (TR.
26). But the ALJ never explains how these findings in Ms. Squire’s records would not
support her opinions that Plaintiff “becomes overwhelmed, experiences panic attacks,
and challenging intrusive thoughts”—they clearly would. In addition to these instances
acknowledged by the ALJ, Ms. Squire’s notes reveal numerous other notations in her
records which support her opinion.
For example, on March 25, 2021, Plaintiff reported minimal improvement in
anxious thoughts, and reported “no significant changes” in her thought process through
November 17, 2021, when she again affirmed “minimal improvement in anxious
thoughts.” (TR. 3312). Thereafter, Plaintiff continued weekly to report “no” significant
changes in her thought processes, affirming that she continued to suffer anxious
thoughts. (TR. 3313). And as noted by the ALJ, on November 29, 2021, Ms. Squire noted
Plaintiff was “having some intrusive thoughts, but does not currently have a plan.” (TR.
3314). A “plan” presumably referred to Plaintiff having a plan to commit suicide, as was
evidenced by Ms. Squire’s notes on December 8th, 15th and 23rd, 2021, when she noted
that Plaintiff was “having thoughts about suicide, but does not have a plan.” (TR. 3315).
At this time, Ms. Squire also noted that Plaintiff was reporting “significant levels of
anxiety” and “minimal improvement.” (TR. 3317).
From December 29, 2021 through January 20, 2022, Plaintiff again reported “no”
changes in her thought processes. (TR. 3318-3321). And as noted by the ALJ, on January
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4, 2022, Plaintiff reported “feeling overwhelmed and tired from eating and not wanting
to do it.” (TR. 3322). On January 31, 2022, Plaintiff reported “no progress toward goals”
and on February 3, 2022, Plaintiff reported “her mood and lack of motivation for
improvement is unchanged.” (TR. 3324). On February 7, 2022, Plaintiff reported that she
had not planned to commit suicide but she had self-harmed. (TR. 3325). On February 10,
2022, Plaintiff reported “significant suicidal ideation,” which would obviously align with
“intrusive thoughts.” (TR. 3327). Plaintiff reported overall improvement from late
February through late June,3 but on June 22, 2022, she again began reporting “significant
levels of anxiety.” (TR. 3349). On September 8, 2022, Plaintiff reported “increase in
anxiety and having a hard time sleeping.” (TR. 3359). On October 6, 2022, Plaintiff
reported “increasing thoughts about self-harm.” (TR. 3363).
In addition to Ms. Squire’s first opinion, the ALJ did not offer an explanation of
why he believed Ms. Squire’s records did not support her findings concerning Plaintiff
becoming overwhelmed in social situations.
See TR. 25-26; 3269. On November 11, 2022,
Ms. Squire noted that Plaintiff had reported anxiety about being around her family for the
holidays and on January 3, 2022, Plaintiff reported having “poor boundaries with most
family members.” (TR. 3368, 3374). On November 30, 2023, Plaintiff reported “prioritizing
her family’s safety and . . . not planning on being around a lot of people over [the]
holidays.” (TR. 3416). On this note, on January 25, 2024, Plaintiff reported a high level
of anxiety associated with her daughter’s upcoming birthday party, which presumably
would involve being around other people in a social situation. (TR. 3423).
3 TR. 3333-3348.
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In sum, the Court finds that again, although facially, the ALJ provided rationales
in support of rejecting Ms. Squire’s opinions as not supported by her own records, but a
review of those records reveals that the ALJ’s rationales lacked substantial evidence.
See
supra. As a result, remand is appropriate.
See supra.
D. Summary
The Court finds that the ALJ erred in his evaluation of significantly probative
evidence related to Plaintiff’s mental health as opined by Ms. Squire. The ALJ provided
facially valid reasons for rejecting the opinions, but his rationales were not supported by
substantial evidence, as discussed above.
VI. PLAINTIFF’S REMAINING ALLEGATIONS OF ERROR
The Court declines to consider Plaintiff’s remaining allegations of error, as they
may be affected “by the ALJ’s treatment of [the] case on remand.”
Watkins v. Barnhart,
350 F.3d 1297, 1299 (10th Cir. 2003).
ORDER
The Court has reviewed the medical evidence of record, the transcript of the
administrative hearing, the decision of the ALJ, and the pleadings and briefs of the parties.
Based on the forgoing analysis, the Court REVERSES AND REMANDS the
Commissioner’s decision.
ENTERED on February 19, 2026.
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