Allison v. Commissioner of Social Security Administration et al

IN THE UNITED STATES DISTRICT COURT FOR THE
WESTERN DISTRICT OF OKLAHOMA
E.A., )
)
Plaintiff, )
)
v. ) Case No. CIV-25-691-R
)
FRANK BISIGNANO, )
Commissioner of the Social Security )
Administration, )
)
Defendant. )
REPORT AND RECOMMENDATION
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 benefits under the Social Security Act. The Commissioner has answered
and filed a transcript of the administrative record (hereinafter TR. ____). This matter has
been referred to the undersigned magistrate judge for initial proceedings consistent with
28 U.S.C. § 636(b)(1)(B)-(C). The parties have briefed their positions, and the matter is
now at issue. It is recommended that the Commissioner’s decision be REVERSED AND
REMANDED.
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. 16-39). The Appeals Council denied Plaintiff’s
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request for review. (TR. 2-4). Thus, the decision of the ALJ became the final decision of
the Commissioner.
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 December 5, 2022, the alleged disability onset date. (TR. 17). At
step two, the ALJ determined Plaintiff suffered from the following severe impairments:
disorders of the skeletal spine; osteoarthritis and allied disorders; left foot pes planus;
obesity; and, sleep related issues. (TR. 18). 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. 21).
At step four, the ALJ concluded that Plaintiff retained the residual functional
capacity (RFC) to:
[P]erform sedentary work as defined in 20 CFR 404.1567(a) except can
never climb ladders, ropes, or scaffolds; can occasionally climb ramps or
stairs; can frequently stoop; and, uses a cane for ambulation.
(TR. 26).
With these limitations, the ALJ concluded that Plaintiff was unable to perform any
past relevant work. (TR. 37). 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. 68). Given the limitations, the VE identified three jobs from the
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Dictionary of Occupational Titles that Plaintiff could perform. (TR. 69). The ALJ then
adopted the VE’s testimony and concluded, at step five, that that Plaintiff was not disabled
based on his ability to perform the identified jobs. (TR. 39).
III. ISSUE PRESENTED
On appeal, Plaintiff alleges error in the ALJ’s failure to properly evaluate: (1)
medical opinions from Plaintiff’s physician and (2) Plaintiff’s subjective statements. (ECF
No. 14:12-20, 22:2-8).
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
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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).
V. ERROR IN THE ALJ’S EVALUATION OF DR. RINGUS’ OPINIONS
Plaintiff alleges legal error in the ALJ’s evaluation of medical opinions from
Plaintiff’s physician, Vytautas Ringus. (ECF No. 14:12-19; 22:2-6). The Court should
agree.
A. Evidence Regarding Plaintiff’s Left Foot, Dr. Ringus’ Opinions, and
the ALJ’s Related Evaluation
On December 8, 2022, at the Orthopaedic Sports Medicine Center, Plaintiff
underwent three surgical procedures on his left foot owing to pain—specifically, a left
subtalar joint arthrodesis, a left talonavicular joint arthrodesis, and a left calcaneocuboid
joint arthrodesis. (TR. 278-281). These procedures involve fusing various bones in
Plaintiff’s foot, with the addition of various metal implants and screws, with the hope of
alleviating pain and restoring function in Plaintiff’s left foot.
See id. Dr. Ringus did not
perform the surgery, but was part of the medical group at the OSMC and became
Plaintiff’s physician for post-operative care and management. (TR. 281). Approximately
three months later, Plaintiff began complaining of right hip and knee pain due to having
to continuously compensate for his left foot pain following the 2022 procedure and he
began using a cane to ambulate. (TR. 411-414). The following month, a physical therapy
note states that he was trained on and released with a single point cane to use for
walking. (TR. 389-390).
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At an August 2023 office visit, Plaintiff reported that he continued to experience
pain in this left ankle and that an injection had helped him for only one day. (TR. 289).
In February of 2024, Plaintiff reported compliance with a bone stimulator, which had been
prescribed for the left ankle pain, but since using it, he had suffered increased pain. (TR.
287). At an April 2024 visit, Plaintiff complained of pain where the hardware had been
implanted and in early May 2024, Plaintiff underwent surgical removal of the same.
See
TR. 620, 623-624. On November 14, 2024, Plaintiff reported that his foot wound was
healing but that it still hurt if he put his full weight on it. (TR. 682). Examination that day
showed Plaintiff as being unable to perform a heel/toe walk and his gait described as
having a “mild antalgic step-through pattern with decreased [weightbearing] on [left]
[lower extremity].” (TR. 680-681). It was also noted at that time that Plaintiff was
continuing to ambulate using a rolling walker “with his left foot turned out and abducted.”
(ECF No. 682).
On November 26, 2024, Dr. Ringus completed a Medical Source Statement. (TR.
784-786). Dr. Ringus stated he was treating Plaintiff for “pain due to internal orthopedic
prosthetic devices, implants and grafts, Disruption of external operation (surgical
wound).” (TR. 784) (internal citation omitted). As a result, Dr. Ringus stated that Plaintiff
could sit, stand, and walk for less than 45 minutes, both at one time AND in a full 8-hour
workday (TR. 784). Dr. Ringus also stated that Plaintiff would need to alternate positions
every 30 minutes and could never lift or carry items of any weight. (TR. 784-785). Finally,
Dr. Ringus stated that Plaintiff would need breaks every hour for 15 minutes. (TR. 786).
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The ALJ acknowledged the opinions, but rejected them as unpersuasive. (TR. 36-
37). In doing so, the ALJ found Dr. Ringus’ opinions to be “not consistent with the medical
treatment record, the claimant’s activities of daily living, the opinions of the State agency
physicians, or with his own imposed limitations” and “not supported by the objective
evidence of record upon serial examinations of the claimant, or the operative reports and
imaging studies of record.” (TR. 36). Specifically, the ALJ found that Dr. Ringus’ opinions
that Plaintiff could neither lift and/or carry nor sit, stand, or walk for greater than 45
minutes total in an entire eight-hour workday, to be “wholly unsupported by the record
elsewhere[.]” (TR. 36). Finally, the ALJ deemed Dr. Ringus’ opinions that Plaintiff could
drive and operate foot controls to be “in direct conflict to his prior imposed limitations.”
(TR. 36).
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
his 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.
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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 she 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 she 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 opinion (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
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
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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C. Error in the ALJ’s Evaluation of Dr. Ringus’ Opinions
In evaluating Dr. Ringus’ opinions, the ALJ facially addressed the factors of
consistency and supportability, as required by the regulations.
See supra,
see TR. 36-37.
But the Court should find neither explanation acceptable.
1. The “Consistency” Factor
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 Dr. Ringus’
opinions were not “not consistent with the medical treatment record, the claimant’s
activities of daily living, [or] the opinions of the State agency physicians” and “not
supported by objective evidence of record upon serial examinations of the claimant, or
the operative reports and imaging studies of record.” (TR. 36).3
The initial problem lies in the fact that the ALJ has made blanket statements that
Dr. Ringus’ opinions are not consistent with the “medical treatment record” and “not
supported by objective evidence of record upon serial examinations of the claimant, or
the operative reports and imaging studies of record.”4 These wholly conclusory
3 The ALJ also found Dr. Ringus’ opinions to be inconsistent with “his own imposed limitations.”
(TR. 36). But this explanation would fall under the “supportability” factor, as discussed below.
See infra.
4 Although the ALJ used the words “not supported by” when referring to “objective evidence of
record upon serial examinations of the claimant, or the operative reports and imaging studies of
record,” the use of the word “support” is of no consequence, as the ALJ was actually comparing
Dr. Ringus’ opinions to other evidence in the record, and not Dr. Ringus’ internal notes, which is
a “consistency” analysis and not a “supportability” analysis.
See supra.
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explanations are simply insufficient.
See Cobb v. Kijakazi, No. CIV-22-551-AMG, 2023 WL
4013336, at *4 (W.D. Okla. June 14, 2023) (“While the ALJ articulated the persuasiveness
of the prior administrative medical findings, his discussion of the supportability and
consistency factors is excessively sparse and conclusory and thus requires remand.”).
Second, the ALJ found that Dr. Ringus’ opinions that Plaintiff could neither lift
and/or carry nor sit, stand, or walk for greater than 45 minutes total in an entire eight-
hour workday, to be “wholly unsupported by the record elsewhere[.]” (TR. 36). Again,
the ALJ cited nothing in support of this statement, but indeed, evidence exists that in
November 2024, Plaintiff was unable to perform a heel/toe walk and his gait was
described as having a “mild antalgic step-through pattern with decreased [weightbearing]
on [left] [lower extremity].” (TR. 680-681). It was also noted at that time that Plaintiff
was continuing to ambulate using a rolling walker “with his left foot turned out and
abducted.” (ECF No. 682).
Third, the ALJ fails to explain how Plaintiff’s activities of daily living were
inconsistent with Dr. Ringus’ opinions. As noted by the ALJ, at the hearing Plaintiff
testified that he:
• Continued to experience left foot pain, which caused issues with his back
and hip as well;
• He used his cane at home;
• He could only stand for 30 minutes at one time;
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• He could only walk for 15-20 minutes at one time and if he did walk, he
would need to rest for 20-30 minutes after doing do; and
• He spends his days alternating positions based on his pain levels.
(TR. 33). Despite the ALJ’s statement to the contrary, Plaintiff’s own testimony concerning
his daily activities seems to be consistent with Dr. Ringus’ opinions regarding Plaintiff’s
limitations in the aforementioned areas.
Finally, the ALJ’s reliance on the opinions of the State Agency medical opinions as
inconsistent with Dr. Ringus’ opinion is incongruous, considering that the State Agency
physicians rendered their opinions in April and July of 2024, and Dr. Ringus did not issue
his opinion until November of 2024.
See supra. In sum, the Court should find that the
ALJ committed legal error in his “consistency” analysis.
2. The Supportability Factor
The Court should also find error in the ALJ’s “supportability” analysis when
evaluating Dr. Ringus’ opinions. Regarding this factor, the only explanation the ALJ
provides for finding that Dr. Ringus’ own records did not support his opinions is that they
were “in direct conflict to his prior imposed limitations” that Plaintiff could drive and
operate foot controls.
See TR. 36. But driving and operating foot controls are activities
that would be done in a seated or reclining position, whereas walking and standing would
involve full weightbearing, which Dr. Ringus specifically noted Plaintiff could not do.
See
supra. Therefore, the Court should also find that although facially the ALJ provided a
rationale in support of rejecting Dr. Ringus’ opinions as not supported by his own records,
the rationale lacked substantial evidence.
See supra. As a result, remand is appropriate.
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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).
VI. PLAINTIFF’S REMAINING ALLEGATIONS OF ERROR
Plaintiff also argues that the ALJ erred in her analysis of Plaintiff’s subjective
statements.
See supra. But the Court should decline consideration of this alleged error
because the analysis of a claimant’s subjective allegations is inexorably intertwined with
the RFC, which may be affected following a remand for further evaluation of the opinions
from Dr. Ringus.
See Watkins v. Barnhart, 350 F.3d 1297, 1299 (10th Cir. 2003) (“We
will not reach the remaining issues raised by appellant because they may be affected by
the ALJ's treatment of this case on remand.”);
see also Poppa v. Astrue, 569 F.3d 1167,
1171 (10th Cir. 2009) (“Since the purpose of the credibility evaluation is to help the ALJ
assess a claimant’s RFC, the ALJ’s credibility and RFC determinations are inherently
intertwined.”);
Roxanna L. H. v. Berryhill, 2019 WL 1083564, at *5–6 (N.D. Okla. Mar. 7,
2019) (finding that the ALJ committed reversible error in his consistency analysis of
Plaintiff’s subjective complaints of pain “which resulted in error in his formulation of
Plaintiff’s RFC[.]”).
VII. RECOMMENDATION AND NOTICE OF RIGHT TO OBJECT
Having 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,
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the undersigned magistrate judge recommends that the decision of the Commissioner be
REVERSED AND REMANDED.
The parties are advised of their right to file specific written objections to this Report
and Recommendation.
See 28 U.S.C. §636 and Fed. R. Civ. P. 72. Any such objections
should be filed with the Clerk of the District Court by May 14, 2026. The parties are
further advised that failure to make timely objection to this Report and Recommendation
waives the right to appellate review of the factual and legal issues addressed herein.
Casanova v. Ulibarri, 595 F.3d 1120, 1123 (10th Cir. 2010).
VIII. STATUS OF REFERRAL
This Report and Recommendation terminates the referral by the District Judge in
this matter.
ENTERED on April 30, 2026.
.
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