Case Name in Social Security Case - Unavailable

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UNITED STATES DISTRICT COURT
MIDDLE DISTRICT OF PENNSYLVANIA
AMY B.,1
Plaintiff,
v.
FRANK BISIGNANO,2
Defendant.
CIVIL ACTION NO. 1:24-CV-02091
(MEHALCHICK, J.)
(LATELLA, M.J.)
REPORT AND RECOMMENDATION
This is an action brought under Section 1383(c) of the Social Security Act
and 42 U.S.C. § 405(g), seeking judicial review of the final decision of the
Commissioner 	of 	Social 	Security 	(hereinafter, 	“the 	Commissioner”) 	denying
Plaintiff Amy B.’s claims for a period of disability benefits under Title XVI of the
1 To protect the privacy interests of plaintiffs in social security cases, we have
adopted the recommendation of the Judicial Conference of the United States that
federal courts should refer to plaintiffs in such cases by their first name and last
initial. See Tammy H. v. Frank Bisignano, Commissioner of Social Security, No.
1:24-cv-00838, Docket No. 19 at n.1 (M.D. Pa. Aug. 27, 2025).
2 “In an official-capacity action in federal court, death or replacement of the named
official will result in automatic substitution of the official's successor in office.”
Kentucky v. Graham, 473 U.S. 159, 166 n.11 (1985) (citing Fed. R. Civ. P.
25(d)(1)). Frank Bisignano was sworn in as the Commissioner of Social Security
on May 7, 2025. Accordingly, we have substituted him as the Defendant in this
action.
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Social Security Act. 	(Doc. 1; Doc. 5-3 at 11). 	This matter was referred to the
undersigned 	federal 	magistrate 	judge 	for 	preparation 	of 	a 	report 	and
recommendation. For the reasons expressed herein, and upon detailed consideration
of the arguments raised by the parties in their respective briefs, we respectfully
recommend that the decision of the administrative law judge be vacated and
remanded.
1. BACKGROUND AND P ROCEDURAL HISTORY
On August 3, 2021, Plaintiff Amy B. (“Ms. B.”) filed an application for Title
XVI benefits. 	(Doc. 5-2 at 18)3. 	In her application, Ms. B. claimed disability
beginning April 27, 2021. (Id.). The Social Security Administration initially denied
Ms. B.’s claims on May 27, 2022, and again upon reconsideration on December 6,
2022. (Id.). Ms. B. filed a request for a hearing before an Administrative Law Judge
(“ALJ”) on January 23, 2023. (Id.). ALJ Sharon Zanotto conducted the requested
hearing on August 17, 2023. (Id.).
In 	a 	written 	opinion 	dated 	February 	28, 	2024, 	ALJ 	Elizabeth 	Ebner
determined that Ms. B. is not disabled and therefore not entitled to the benefits
sought. 	(Id. at 30). 	Ms. B. appealed the ALJ’s decision to the Appeals Council,
3 For the sake of clarity, we refer to the NextGen/ECF document numbers and
pagination in our citations.
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who, on October 8, 2024, denied Ms. B.’s request for review. (Doc. 5-2 at 2). On
December 4, 2024, Ms. B. filed the instant action. 	(Doc. 1). 	The Commissioner
responded on January 22, 2025, providing the requisite transcripts from the disability
proceedings on August 17, 2023. (Docs. 4, 5). The parties then filed their respective
briefs (Docs. 13, 14, 19), with Plaintiff alleging three errors warranting reversal or
remand. (Doc. 13 at 1).
2. THE ALJ’ S D ECISION
In a decision dated February 28, 2024, the ALJ determined Ms. B. “has not
been under a disability, as defined in the Social Security Act since August 3, 2021,
the date the application was filed.” 	(Doc. 5-2 at 30). 	The ALJ reached this
conclusion after proceeding through the five-step sequential analysis required by the
Social Security Act. See 20 C.F.R. § 416.920(a).
At step one, an ALJ must determine whether the claimant is engaging in
substantial gainful activity (“SGA”). 20 C.F.R § 416.920(a)(4)(i). If a claimant is
engaging in SGA, the Regulations deem them not disabled, regardless of age,
education, or work experience. 	20 C.F.R. § 416.920(b). 	SGA is defined as work
activity—requiring significant physical or mental activity—resulting in pay or
profit. 20 C.F.R. § 416.972. In making this determination, the ALJ must consider
only the earnings of the claimant. 20 C.F.R. § 416.974. The ALJ determined Ms.
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B. “has not engaged in [SGA] since August 3, 2021, the application date.” (Doc. 5-
2 at 20). Thus, the ALJ’s analysis proceeded to step two.
At step two, the ALJ must determine whether the claimant has a medically
determinable impairment that is severe or a combination of impairments that are
severe. 20 C.F.R. § 416.920(a)(4)(ii). If the ALJ determines that a claimant does
not have an “impairment or combination of impairments which significantly limits
[the claimant’s] physical or mental ability to do basic work activities, [the ALJ] will
find that [the claimant] does not have a severe impairment and [is], therefore, not
disabled.” 20 C.F.R. § 416.920(c). If a claimant establishes a severe impairment or
combination of impairments, the analysis continues to the third step.
The ALJ found Ms. B. has the following severe impairments: obesity, Patent
Foramen Ovale (PFO), migraine headaches, anxiety, and depression. (Doc. 5-2 at
20). The ALJ also identified Ms. B.’s non-severe impairments as: gastroesophageal
reflux disease (GERD), vasovagal syncope, and obstructive sleep apnea. (Doc. 5-2
at 20).
At step three, the ALJ must determine whether the severe impairment or
combination 	of 	impairments 	meets 	or 	equals 	the 	medical 	equivalent 	of 	an
impairment listed in 20 C.F.R. § 416.920(a)(4)(iii); 416.925; 416.926. 	If the ALJ
determines that the claimant’s impairments meet these listings, then the claimant is
considered disabled. 20 C.F.R. § 416.920(d). The ALJ determined that none of Ms.
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B.’s impairments, considered individually or in combination, met or equaled a
Listing. 	(Doc. 5-2 at 21). 	The ALJ stated that she considered whether Ms. B.’s
migraine condition meets or equals the requirements of any pertinent physical or
mental listing in accordance with SSR 19-4p, but that the signs, symptoms, and
laboratory findings are not of such severity as those found in any listing. (Id.). The
ALJ likewise found that the signs, symptoms, and laboratory findings of Ms. B.’s
obesity are not of such severity as those found in any listing. (Id.). Finally, the ALJ
stated that the severity of Ms. B.’s mental health impairments, considered singly and
in combination, do not meet or medically equal the criteria of listings 12.04 and
12.06. (Id.).
Between steps three and four, the ALJ determines the claimant’s residual
functional capacity (“RFC”), crafted upon consideration of the medical evidence
provided. The ALJ determined that:
[Ms. B]. has the residual functional capacity to perform a
full range of work at all exertional levels but with the
following nonexertional limitations: The claimant can
never climb ladders, ropes, or scaffolds. The claimant
should avoid all jobs requiring her to taste or smell various
flavors or odors. The claimant should avoid all exposure
to dust, fumes, odors, gases, chemicals, hot or cold
temperature extremes, wetness, and humidity; and the
claimant can tolerate no louder than a moderate voice
level. The claimant should avoid all exposure to moving
machinery, sharp tools, open flames, and bodies of water.
Finally, 	the 	claimant 	is 	limited 	to 	understanding,
remembering, and carrying out tasks involving simple
instructions and using judgment to make simple decisions,
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with no more than occasional work setting process and
tool changes.
(Doc. 5-2 at 23).
Having assessed a claimant’s RFC, at step four the ALJ must determine
whether the claimant has the RFC to perform the requirements of their past relevant
work. 20 C.F.R. § 416.920(a)(4)(iv). A finding that the claimant can still perform
past relevant work requires a determination that the claimant is not disabled. 	20
C.F.R. § 416.920(a)(4)(iv). Past relevant work is defined as work the claimant has
done within the past 15 years, that was substantial gainful activity, and that lasted
long enough for the claimant to learn how to do it. 20 C.F.R. § 416.960(b). If the
claimant cannot perform past relevant work or has no past relevant work, then the
analysis proceeds to the fifth step.
The ALJ determined that Ms. B.is unable to perform past relevant work.
(Doc. 5-2 at 29). The ALJ noted past relevant work as a Substance Abuse Counselor,
but the demands of that work exceeded Ms. B.’s RFC. (Id.).
At step five of the sequential analysis process, an ALJ considers the claimant’s
age, education, and work experience to see if a claimant can make the adjustment to
other work. 20 C.F.R. § 416.920(a)(4)(iv). These factors are not considered when
evaluating a claimant’s ability to perform past relevant work. 	20 C.F.R. §
416.960(b)(3). 	If a claimant has the ability to make an adjustment to other work,
they will not be considered disabled. 20 C.F.R. § 416.920(a)(4)(iv).
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The ALJ made vocational determinations that on the date of her application,
Ms. B. was 24 years, defined as a younger individual age 18-49 by the Regulations.
20 C.F.R. § 404.1563. 	(Doc. 5-2 at 29). 	The ALJ also noted that Ms. B. “has at
least a high school education” as considered in 20 C.F.R. § 416.964. (Doc. 7-2 at
35). 	The ALJ determined that upon consideration of these factors, Ms. B.’s RFC,
and the testimony of a vocational expert, “there are jobs that exist in significant
numbers in the national economy that the claimant can perform.” 	(Id.). 	The ALJ
specifically identified occupations of marker, cashier II, and routing clerk. 	(Id. at
30).
As a result of this analysis, the ALJ determined that Ms. B. was not disabled
and denied her applications for benefits. (Id.).
3. STANDARD OF R EVIEW
In order to receive benefits under Title XVI of the Social Security Act, a
claimant must demonstrate an “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. § 1382c(a)(3)(A). 	To
satisfy 	this 	requirement, 	a 	claimant 	must 	have 	a 	severe 	physical 	or mental
impairment that makes it impossible to do his or her previous work or any other
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substantial 	gainful 	activity that 	exists 	in 	significant 	numbers 	in 	the 	national
economy. 20 C.F.R. § 416.905(a).
In evaluating whether a claimant is disabled as defined in the Social Security
Act, the Commissioner follows a five-step sequential evaluation process. 20 C.F.R.
§ 416.920(a). Under this process, the Commissioner must determine, in sequence:
(1) whether the claimant is engaged in substantial gainful activity; (2) whether the
claimant has a severe impairment; (3) whether the claimant's impairment meets or
equals a listed impairment; (4) whether the claimant is able to do past relevant work,
considering his or her residual functional capacity (“RFC”); and (5) whether the
claimant is able to do any other work that exists in significant numbers in the national
economy, considering his or her RFC, age, education, and work experience. 	20
C.F.R. § 416.920(a). 	The claimant bears the initial burden of demonstrating a
medically determinable impairment that prevents him or her from doing past
relevant work. 20 C.F.R. § 416.912(a). 	Once the claimant has established at step
four that he or she cannot do past relevant work, the burden then shifts to the
Commissioner at step five to show that jobs exist in significant numbers in the
national economy that the claimant could perform that are consistent with his or her
RFC, age, education, and past work experience. 20 C.F.R. § 416.912(f).
In 	reviewing 	the 	Commissioner's 	final 	decision 	denying 	a 	claimant's
application for benefits, the Court's review is limited to determining whether the
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findings of the final decision-maker are supported by substantial evidence in the
record. See 42 U.S.C. § 405(g); Johnson v. Comm'r of Soc. Sec., 529 F.3d 198, 200
(3d Cir. 2008); Ficca v. Astrue, 901 F. Supp. 2d 533, 536 (M.D. Pa. 2012).
Substantial evidence “does not mean a large or considerable amount of evidence, but
rather such relevant evidence as a reasonable mind might accept as adequate to
support a conclusion.” 	Pierce v. Underwood, 487 U.S. 552, 565 (1988) (internal
quotations omitted). 	Substantial evidence is less than a preponderance of the
evidence but more than a mere scintilla. Richardson v. Perales, 402 U.S. 389, 401
(1971). 	A single piece of evidence is not substantial evidence if the ALJ ignores
countervailing evidence or fails to resolve a conflict created by the evidence. Mason
v. Shalala, 994 F.2d 1058, 1064 (3d Cir. 1993). In an adequately developed factual
record, however, substantial evidence may be “something less than the weight of the
evidence, and the possibility of drawing two inconsistent conclusions from the
evidence does not prevent [the ALJ's decision] from being supported by substantial
evidence.” 	Consolo v. Fed. Mar. Comm'n, 383 U.S. 607, 620 (1966). 	“In
determining if the Commissioner's decision is supported by substantial evidence the
court must scrutinize the record as a whole.” 	Leslie v. Barnhart, 304 F. Supp. 2d
623, 627 (M.D. Pa. 2003). The question before the Court, therefore, is not whether
Ms. B.is disabled, but whether the Commissioner's finding that she is not disabled is
supported by substantial evidence and was reached based upon a correct application
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of the relevant law. 	See Arnold v. Colvin, No. 3:12-CV-02417, 2014 WL 940205,
at *1 (M.D. Pa. Mar. 11, 2014) (“[I]t has been held that an ALJ's errors of law denote
a lack of substantial evidence.”); Burton v. Schweiker, 512 F. Supp. 913, 914 (W.D.
Pa. 1981) (“The [Commissioner]'s determination as to the status of a claim requires
the correct application of the law to the facts.”); see also Wright v. Sullivan, 900 F.2d
675, 678 (3d Cir. 1990) (noting that the scope of review on legal matters is
plenary); Ficca v. Astrue, 901 F. Supp. 2d 533, 536 (M.D. Pa. 2012) (“[T]he court
has plenary review of all legal issues decided by the Commissioner.”).
4. D ISCUSSION
Ms. B. argues that the ALJ erred in three ways. 	First, she claims that
substantial evidence does not support the ALJ’s step three analysis regarding her
migraine headaches. 	(Doc. 13 at 1). 	Second, she argues that the ALJ failed to
address her need to lie down during the day. 	(Id.). 	Finally, she argues that
substantial evidence does not support the ALJ’s mental RFC assessment. (Id.).
In response, the Commissioner maintains that Ms. B. “has not established that
her migraine headaches individually or in combination satisfy the heightened
requirements of any listing.” 	(Doc. 14 at 10). 	Regarding Plaintiff’s other two
claims, the Commissioner argues that the ALJ’s RFC was supported by substantial
evidence as the ALJ “properly considered such factors as the objective medical
evidence, medical opinions, daily activities, type of pain/symptoms, precipitating
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and aggravating factors, medication and other treatment, any other measures used to
relief 	symptoms, 	and 	any 	other 	factors 	concerning 	functional 	limitations, 	in
determining that Plaintiff’s statements were inconsistent with the evidence of
record.” (Id. at 12).
A. T HE ALJ’ S CONSIDERATION OF MS. B.’ S MIGRAINES AT STEP 3
Appendix 1 of 20 C.F.R. Part 404, Subpart P (“Listing of Impairments”)
describes, 	for 	each 	major 	body 	system, 	impairments 	that 	the 	Commissioner
considers to be severe enough to prevent a claimant from doing any gainful activity
regardless of the claimant's age, education, or work experience. 	Bowen v. Yuckert,
482 U.S. 137, 153 (1987); Knepp v. Apfel, 204 F.3d 78, 85 (3d Cir. 2000).
“Each impairment is defined in terms of several specific medical signs,
symptoms, or laboratory test results.” Sullivan v. Zebley, 493 U.S. 521, 530 (1990).
“[T]he medical criteria defining the listed impairments” is set “at a higher level of
severity than the statutory standard.” 	Id. at 532. “The listings define impairments
that would prevent an adult, regardless of his age, education, or work experience,
from performing any gainful activity, not just ‘substantial gainful activity.’” 	Id.
“The reason for this difference between the listings' level of severity and the
statutory standard is that, for adults, the listings were designed to operate as a
presumption of disability that makes further inquiry unnecessary.” Id. If a claimant's
impairment meets or is equivalent to a listed impairment at step three of the analysis,
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then the claimant “is per se disabled and no further analysis is necessary.” Burnett
v. Comm'r of Soc. Sec. Admin., 220 F.3d 112, 119 (3d Cir. 2000). But “[i]f a claimant
does not suffer from a listed impairment or its equivalent, the analysis proceeds to
steps four and five.” Plummer v. Apfel, 186 F.3d 422, 428 (3d Cir. 1999).
The Third Circuit requires the ALJ to set forth the reasons for his or her
determination as to whether a claimant’s condition meets or equals a listing. Burnett,
220 F.3d at 119. The purpose of this requirement “is to ensure that there is sufficient
development of the record and explanation of findings to permit meaningful review.”
Jones v. Barnhart, 364 F.3d 501, 505 (3d Cir. 2004) (citing Burnett, 220 F.3d at
120). “[A]n ALJ need not ‘use particular language or adhere to a particular format
in conducting analysis’ so long as ‘the ALJ's decision, read as a whole, illustrates
that the ALJ considered the appropriate factors in reaching the conclusion that
[claimant] did not meet the requirements for any [L]isting.’” Gonzalez v. Saul, No.
1:17-cv-02524 (PAZ), 2019 WL 13401378, *12 (D.N.J. Oct. 31, 2019) (alteration
in original) (quoting Jones, 364 F.3d at 505).
There is no listing for migraine headaches. See Soc. Sec. Ruling 19-4p, Titles
II & XVI: Evaluating Cases Involving Primary Headache Disorders, 2019 WL
4169635 (S.S.A. Aug. 26, 2019) (“SSR 19-4p”) (“Primary headache disorder is not
a listed impairment in the Listing of Impairments (listings).”). However, “SSR 19-
4p explains how primary headache disorders, like migraines, are evaluated at step
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three.” 	Tyson v. Kijakazi, 1:21-CV-855, 2022 WL 3975002, at *10 (M.D. Pa. July
25, 2022), report and recommendation adopted, 2022 WL 3971041 (M.D. Pa. Aug.
31, 2022)). 	SSR 19-4p provides that “a primary headache disorder, alone or in
combination with another impairment(s)” may “medically equal[ ] a listing.” 	SSR
19-4p, 2019 WL 4169635 at *7. 	SSR 19-4p identifies Listing 11.02, which
addresses epilepsy, as “the most closely analogous listed impairment” for a primary
headache disorder. 	Id. 	More specifically, SSR 19-p4 provides that “[w]hile
uncommon, a person with a primary headache disorder may exhibit equivalent signs
and limitations to those detailed in listing 11.02 (paragraph B or D for dyscognitive
seizures), and we may find that his or her MDI(s) [medically determinable
impairment(s)] medically equals the listing.” 	Id. 	“Thus, an ALJ should look to
Listings 11.02B and 11.02D in assessing whether a claimant's migraine headache
impairment medically equals a listing.” Tyson, 2022 WL 3975002 at *10.
“Listing 11.02B describes dyscognitive seizures ‘occurring at least once a
week 	for 	at 	least 	3 	consecutive 	months 	... 	despite 	adherence 	to 	prescribed
treatment.’” 	Falardo-Weller v. Kijakazi, NO. 3:22-CV-01026, 2023 WL 6119101,
*6 (M.D. Pa. Sept. 18, 2023) (quoting 20 C.F.R. Part 404, Subpart P, App.1, §
11.02B). 	In evaluating a claimant with migraines, an ALJ should look to the
following factors to determine whether that impairment medically equals listing
11.02B:
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[(1)] A detailed description from an AMS of a typical
headache event, including all associated phenomena (for
example, premonitory symptoms, aura, duration, intensity,
and accompanying symptoms); [(2)] the frequency of
headache events; [(3)] adherence to prescribed treatment;
[(4)] 	side 	effects 	of 	treatment 	(for 	example, 	many
medications used for treating a primary headache disorder
can produce drowsiness, confusion, or inattention); and
[(5)] 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).
SSR 19-4P, 2019 WL 4169635 at *7.
Listing 11.02D, on the other hand, “requires 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” of the following: “physical
functioning; understanding, remembering, or applying information; interacting with
others; concentrating, persisting or maintaining pace; or adapting or managing
oneself.” 	Id. 	In evaluating Listing 11.02D, ALJs will also consider “the same
factors ... consider[ed] for 11.02B[.]” Id.
Here, at step three, the ALJ’s analysis of Ms. B.’s migraines is limited to the
following:
While headaches/migraines are not a listed impairment,
the undersigned has specifically considered whether the
claimant’s condition meets or equals the requirements of
any pertinent physical or mental listing in accordance with
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SSR 19-4p. However, the signs, symptoms and laboratory
findings of the claimant’s condition are not of such
severity as found in any listing.
(Doc. 5-2 at 21). 	The ALJ did not discuss or cite Listing 11.02B or 11.02D in
addressing Ms. B.’s migraines. 	While it is “preferable for an ALJ to ‘specifically
identify the listed impairments under consideration,” that “omission, standing alone,
is not dispositive.” Tyson, 2022 WL 3975002, at *10 (quoting Arroyo v. Comm'r of
Soc. Sec., 155 F. App'x 605, 608 (3d Cir. 2005). Rather, we must consider whether
the “ALJ's decision clearly analyzes and evaluates the relevant medical evidence as
it relates to the Listing requirements.” Scuderi v. Comm'r of Soc. Sec., 302 F. App'x
88, 90 (3d Cir. 2008) (emphasis added).
Thus, we consider the ALJ’s analysis of Ms. B.’s migraines later in the
decision. The ALJ summarized Ms. B.’s testimony with respect to her migraines as
follows:
The claimant testified that she is has cognitive issues when
she has a migraine; and she has trouble standing, walking,
and reading. The claimant testified that she has vestibular
migraines several days a week, which cause dizziness and
vomiting; she has abdominal migraines; and she has ocular
migraines. The claimant testified that she takes medication
for her migraines; sounds, scents, weather, some foods,
and some drinks exacerbate her migraines; and sleep, cold
compresses, 	and 	peppermint 	essential 	oil 	help 	her
migraines.
(Doc. 5-2 at 23). The ALJ subsequently noted that, “After careful consideration of
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the evidence, the undersigned finds that the claimant’s medically determinable
impairments could reasonably be expected to cause the alleged symptoms; however,
the claimant’s statements concerning the intensity, persistence and limiting effects
of these symptoms are not entirely consistent with the medical evidence and other
evidence in the record for the reasons explained in this decision.” (Id. at 24).
Later in the decision, the ALJ summarized the medical evidence. Regarding
migraines, the ALJ cited a July 26, 2021 examination for migraines where Ms. B.
reported having headaches consistent with migraines since early childhood, but
noted that they had gradually worsened especially over the past two years. (Id.). It
was noted that Ms. B. used Fioricet excessively and that this medication over-use
likely contributed to her current headache problems. (Id.). The ALJ then noted that
during a July 28, 2021 office visit, Ms. B. reported dizziness occurring with
migraines. 	(Id.). 	She indicated at this visit, however, that she was seeing a
neurologist 	for 	migraines. 	(Id.). 	During 	a 	November 	18, 	2021 	follow-up
appointment, the ALJ noted that Ms. B. reported much better control of migraines
on Aimovig. (Id.). The ALJ then referenced a January 19, 2022 visit where Ms. B.
reported a moderate reduction in headache severity and frequency over the past few
months, averaging 5-10 migraine headache days. (Id. at 25). The ALJ also noted
that Ms. B. was diagnosed with chronic migraine without aura without status-
migrainous. 	(Id.). 	The ALJ stated that during a neurology follow-up on May 24,
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2022, Ms. B. denied any significant changes to the nature, severity, or frequency of
her headaches since the prior appointment. 	(Id.). 	However, Ms. B. reported that
since starting the higher dose of propranolol, she continued with an increase in
lightheadedness/dizziness episodes. (Id.). The ALJ then referenced a September 27,
2022 follow-up appointment during which Ms. B. presented with complaints of
increased dizziness, nausea, and migraine severity with rebound headaches since
starting Nurtec every other day dosing. The ALJ also noted that on November 22,
2022, Ms. B. reported that her headaches had improved after stopping contraception.
(Id.). 	The ALJ added that in December 2022, Ms. B. received her first round of
Botox injections, and on December 22, 20222, she reported that her migraines were
better controlled on Aimovig. (Id.). Finally, the ALJ stated that on March 2, 2023,
during an office visit for her second round of Botox injections, she reported a
moderate improvement in her headache severity.
We cannot say that substantial evidence supports the ALJ’s conclusion that
Ms. B.’s migraines do not meet or equal a listing. 	Unfortunately, the ALJ’s failure
to specifically reference and discuss Listings 11.02B and 11.02D significantly
hinders our ability to perform a meaningful review of that conclusion. 	However,
consideration of the medical evidence discussed by the ALJ as well as evidence in
the medical record that was not discussed suggests that Ms. B.’s migraines may be
sufficient to meet or equal a listing.
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The frequency requirement in Listing 11.02B provides that the migraines must
occur “at least once a week for at least 3 consecutive months.” 	Tyson, 2022 WL
3975002, at *11 (citing 20 C.F.R. Part 404, Subpart P, App.1, § 11.02B; see also
Corey Z. v. Saul, No. 18 CV 50219, 2019 WL 6327427, at *4 (N.D. Ill. Nov. 26,
2019) (“Courts analyzing migraine headaches under listing 11.02 have found that
equivalence can be shown where migraines occur at these time intervals despite
prescribed treatment.”) (citation omitted)). The ALJ referenced a January 19, 2022
visit where Ms. B. reported a moderate reduction in headache severity and frequency
over the past few months, averaging 5-10 migraine headache days per month. (Id.
at 25). While the ALJ indicated that Ms. B. reported improvement during a March
2023 appointment, those records indicate that Ms. B. was still reporting “8+
migrainous headache days per month.” (Doc. 5-7 at 344). And records from a prior
appointment three months earlier in December 2022 likewise indicate that Ms. B.
reported “8+ migrainous headache days per month.” (Id. at 347). Thus, for at least
three months – December 2022 through March 2023 – Plaintiff appears to have
satisfied the frequency requirement.
Listing 11.02B also requires that the migraines persisted notwithstanding
“adherence to prescribed treatment.” 	20 C.F.R. Part 404, Subpart P, App.1, §
11.02B. Aside from a reference to a July 26, 2021 note that indicated that Ms. B.’s
overuse of Fioricet likely contributed to her headache issues, we are not aware of
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any additional evidence suggesting that Ms. B. did not adhere to her treatment
regimens. 	Rather, it appears as though she consistently sought treatment and
attempted many different medication and therapy regimens in an effort to control
her condition. 	As this court has explained when considering similar facts, “[t]he
explanatory comments for the neurological listings discuss how the Commissioner
will “consider adherence to prescribed treatment”:
“Despite adherence to prescribed treatment” means that
you have taken medication(s) or followed other treatment
procedures for your neurological disorder(s) as
prescribed by a physician for three consecutive months
but your impairment continues to meet the
other listing requirements despite this treatment. You
may receive your treatment at a health care facility that
you visit regularly, even if you do not see the same
physician on each visit.
Tyson, 2022 WL 3975002, at *13 (quoting 20 C.F.R. Part 404, Subpart P, App.1, §
11.00C). In Tyson, the court concluded that notwithstanding reference by the ALJ
to the plaintiff’s overuse of a certain medication, “[t]here was no evidence that
[plaintiff] failed to take her prescribed medications or failed to try any other
treatment procedures recommended by her doctors.” 2022 WL 3975002, at *14. To
the contrary, consistent with physician recommendations, the plaintiff in that case
tried Botox and multiple different medications over the years. 	Id. 	Likewise here,
neither the ALJ nor the Commissioner has cited to any evidence suggesting that Ms.
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B. failed to take her prescribed medications or failed to try other treatment
procedures recommended by her physicians.
Thus, the record evidence tends to suggest Ms. B. may meet the requirements
of Listing 11.02B. 	However, the ALJ’s failure to “evaluate on the record the
applicability of 11.02B and D . . . ‘prevents the Court from conducting a meaningful,
albeit deferential review.’” Fewell v. O’Malley, CIV. No. 1:23-cv-00865, 2024 WL
4182115, at *6 (M.D. Pa. Aug. 19, 2024) (quoting Falardo-Weller v. Kijakazi, No.
3:22-CV-01026, 2023 WL 6119101, *6 (M.D. Pa. Sept. 18, 2023). Because of this
error, we recommend that the decision be vacated. 	See Tyson, 2022 WL 3975002,
at *15 (similarly vacating decision based upon inability to conduct meaningful
review of finding that plaintiff’s migraines did not meet or equal a listing); Fewell,
2024 WL 4182115, at *6 (same).
B. PLAINTIFF’ S REMAINING A RGUMENTS
Because it will be recommended that the decision of the Commissioner be
vacated and remanded for further consideration so that the ALJ may properly
consider Listings 11.02B and 11.02D, Plaintiff’s remaining arguments need not be
addressed. 	“A remand may produce different results on these claims, making
discussion of them moot.” 	Burns v. Colvin, 156 F. Supp. 3d 579, 598 (M.D. Pa.
2016). Evaluation of Plaintiff’s additional contentions would be futile given that the
ALJ's reconsideration of Plaintiff’s limitations may yield a different result.
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C. REMEDY
The Court has authority to affirm, modify or reverse the Commissioner's
decision 	“with 	or without 	remanding 	the case 	for 	rehearing.” 	42 	U.S.C. §
405(g); Melkonyan v. Sullivan, 501 U.S. 89, 100-01 (1991). 	However, the Third
Circuit has advised that benefits should only be awarded where “the administrative
record of the case has been fully developed and when substantial evidence in the
record 	as 	a 	whole 	indicates 	that 	the 	claimant 	is 	disabled 	and 	entitled 	to
benefits.” 	Morales v. Apfel, 225 F.3d 310, 320 (3d Cir. 2000). 	See generally Fla.
Power & Light Co. v. Lorion, 470 U.S. 729, 744 (1985) (“[T]he proper course,
except in rare circumstances, is to remand to the agency for additional investigation
or explanation.”). 	Because the ALJ’s decision was not supported by substantial
evidence, the undersigned United States Magistrate Judge respectfully recommends
that further development of the record is required, and that the decision of the
Commissioner 	be 	vacated 	and 	that 	the 	case 	be 	remanded.
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5. R ECOMMENDATION
Based on the foregoing, pursuant to sentence four of 42 U.S.C. § 405(g), it is
recommended that the Commissioner’s decision be vacated and that the case be
remanded 	to the Commissioner to fully develop the record, conduct a new
administrative hearing, and appropriately evaluate the evidence. 	It is further
recommended that the Clerk of Court be directed to CLOSE this case.
Dated: January 28, 2026 	s/ Leo A. Latella
LEO A. LATELLA
United States Magistrate Judge
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UNITED STATES DISTRICT COURT
MIDDLE DISTRICT OF PENNSYLVANIA
AMY B.,
Plaintiff,
v.
FRANK BISIGNANO,
Defendant.
CIVIL ACTION NO. 1:24-CV-02091
(MEHALCHICK, J.)
(LATELLA, M.J.)
NOTICE
NOTICE IS HEREBY GIVEN 	that the undersigned has entered the
foregoing Report and Recommendation dated January 28, 2026.
Any party may obtain a review of the Report and Recommendation pursuant
to Rule 72.3, which provides:
Any party may object to a magistrate judge’s proposed findings,
recommendations or report addressing a motion or matter described in
28 	U.S.C. 	§ 	636(b)(1)(B) 	or 	making 	a 	recommendation 	for 	the
disposition of a prisoner case or a habeas corpus petition within
fourteen (14) days after being served with a copy thereof. Such party
shall file with the clerk of court, and serve on the magistrate judge and
all parties, written objections which shall specifically identify the
portions of the proposed findings, recommendations or report to which
objection is made and the basis for such objections. 	The briefing
requirements set forth in Local Rule 72.2 shall apply. 	A judge shall
make a de novo determination of those portions of the report or
specified proposed findings or recommendations to which objection is
made and may accept, reject, or modify, in whole or in part, the findings
or recommendations made by the magistrate judge. 	The judge,
however, need conduct a new hearing only in his or her discretion or
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where required by law, and may consider the record developed before
the magistrate judge, making his or her own determination on the basis
of that record. 	The judge may also receive further evidence, recall
witnesses 	or 	recommit 	the 	matter 	to 	the 	magistrate 	judge 	with
instructions.
Dated: January 28, 2026 	s/ Leo A. Latella
LEO A. LATELLA
United States Magistrate Judge
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