Kathryn A. Laplante v. Commissioner of Social Security

NOT RECOMMENDED FOR PUBLICATION
File Name: 24a0054n.06
No. 23-1460
UNITED STATES COURT OF APPEALS
FOR THE SIXTH CIRCUIT
KATHRYN A. LAPLANTE,
Plaintiff-Appellant
v.
COMMISSIONER OF SOCIAL SECURITY,
Defendant-Appellee
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ON APPEAL FROM THE
UNITED STATES DISTRICT
COURT FOR THE EASTERN
DISTRICT OF MICHIGAN
OPINION
Before: GIBBONS, WHITE, and THAPAR, Circuit Judges.
HELENE N. WHITE, Circuit Judge. Kathryn LaPlante appeals the denial of her
application for child disability benefits (CDB) and supplemental security income (SSI) under the
Social Security Act. LaPlante argues that the administrative law judge (ALJ) erred in her analysis
of LaPlante’s pseudoseizures—non-epileptic seizures often caused by psychological trauma. The
district court found no error in the ALJ’s analysis. We AFFIRM in part and REVERSE in part.
I.
LaPlante first applied for CDB and SSI in November 2018, when she was nineteen years
old, alleging disability based on numerous conditions. Following a hearing in June 2020, an ALJ
determined that LaPlante had several severe impairments, including migraines, pseudoseizures,
and other psychological disorders, but concluded that she was not disabled. This appeal focuses
primarily on LaPlante’s pseudoseizures, which are “attacks that resemble epilepsy-related seizures
in symptoms and signs” but are not caused by “abnormal electrical activity” in the brain.
Cleveland Clinic, Psychogenic Nonepileptic Seizure (PNES), https://my.clevelandclinic.org

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/health/diseases/24517-psychogenic-nonepileptic-seizure-pnes (last visited Dec. 29, 2023).
Instead, pseudoseizures are “a physical reaction to underlying psychological distress” and are best
treated by diagnosing and treating underlying psychiatric symptoms. Id.
A.
The medical records show that LaPlante has a history of mental disorders and struggles
with anxiety and depression, among other issues. As early as 2017, LaPlante was experiencing
episodes where “everything goes black for a second,” and her doctor diagnosed her with
“conversion disorder”—a general term for mental-health conditions that cause physical
symptoms—and instructed her to “follow up with psychiatry.” R.8-8, PageID 1339–40. In March
2019, LaPlante’s family found her at home, unresponsive, and called EMS. After a short stay in
the hospital, LaPlante reported feeling “weird” but presented as asymptomatic. Id. at PageID 1142.
She was advised to follow up with her primary-care physician about the episode, which her medical
records suggest was caused by conversion disorder. LaPlante’s father told a doctor in April 2019
that, starting two to three months prior, LaPlante had been having these episodes two to three times
per week, and during the episodes, she has “an extension of her neck and her eyes rolled
backwards.” Id. at PageID 1289. A few weeks later, LaPlante had a video EEG study that ruled
out epileptic seizures. During the study, LaPlante had “multiple episodes” of “random movements
of arms or legs, or jerking movements, flailing in the bed,” but “none of these were associated with
electrographic changes.” Id. at PageID 1372.
LaPlante’s primary-care doctor told LaPlante in May 2019 that she should not drive due to
her pseudoseizures. A few weeks later, LaPlante underwent a diagnostic assessment with Dr.
Gayle Oliver-Brannon, who administered a series of tests to assess her mental status. Dr. Oliver-
Brannon concluded that “the pressure of employment would be a major factor in decompensation

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on her part” and that LaPlante “does not present as a viable candidate for employment.” R.8-8,
PageID 1211. She noted, however, that “if employment is considered some restrictions may be
needed.” Id. On May 13, LaPlante’s psychiatrist, Dr. Vishwas Mashalkar, wrote in his notes that
LaPlante had been diagnosed with “non epileptic seizures” that were “psychogenic in nature” and
thus “should not limit her ability to work.” Id. at PageID 1392. Later that month, after reviewing
LaPlante’s medical file, a state psychological consultant concluded that LaPlante was “able to do
simple work with sustainability and persistence.” R.8-3, PageID 205.
Throughout 2019 and early 2020, LaPlante saw various doctors who noted that she
continued to report migraines and pseudoseizures. She started treatment with a new psychiatrist,
Dr. Kettie Joseph Daniels, who evaluated her mental capacity in April 2020. R.8-9, PageID 1804–
10. Dr. Daniels assessed the degree to which LaPlante could exercise certain functions and
concluded that for almost all categories, LaPlante would have either a “mild” restriction or her
ability to function or would be “seriously limited but not precluded.” Dr. Daniels identified one
area of functioning in which LaPlante would be unable to “satisfactorily perform[] . . .
independently, appropriately, effectively, and on a sustained basis in a regular work setting”: the
ability to complete a normal workday and workweek without psychologically based symptoms
interrupting her and perform at a consistent pace. Id. at PageID 1804, 1808. She nonetheless
concluded that LaPlante would be off task over 20% of the time and that she would be unable to
work two to four days per month.
B.
Following a hearing on LaPlante’s claims in June 2020, the ALJ conducted the five-step
inquiry required by Social Security regulations, see 20 C.F.R. § 404.1520, and concluded that
LaPlante was not disabled. At Step One, the ALJ found that LaPlante was not engaged in

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substantial gainful activity. At Step Two, the ALJ assessed each of LaPlante’s impairments and
found that she had numerous severe impairments, including pseudoseizures and conversion
disorder.1 Step Three required the ALJ to consider whether LaPlante had an impairment or
combination of impairments that met or medically equaled one of the listed impairments in the
appendix to 20 C.F.R. Part 404, Subpart P, appendix 1. The ALJ concluded that she did not, and
that LaPlante had the residual functional capacity (RFC) to perform light work with restrictions.
Relevant here, the ALJ concluded that due to her pseudoseizures and migraines, LaPlante’s
limitations included “no commercial driving, no exposure to extreme temperatures, no more than
moderate noise level, and no work around unprotected heights, moving mechanical machinery, or
around areas where [LaPlante] would be exposed to large bodies of open water, open flames, or
sharp unprotected implements.” R.8-2, PageID 62. The ALJ also included limitations related to
LaPlante’s mental capacity, noting, for example, that she can carry out “simple, routine tasks but
not a production rate pace such as required working on an assembly line or conveyor belt.” Id. at
PageID 55.
Step Four assesses a claimant’s past relevant work, of which LaPlante had none. Finally,
at Step Five, the ALJ considered LaPlante’s residual functional capacity and found that there are
sufficient jobs in the national economy that she could perform, such as an office helper or
mailroom clerk.
1 The ALJ found that LaPlante had the following severe impairments: migraines/menstrual
migraines; fibromyalgia; pseudoseizures; synovial plica syndrome of the bilateral knees; right hip
impingement syndrome; interstitial cystitis, status-post cystoscopy; pelvic pain syndrome; and
psychological conditions variously described as: attention deficit hyperactivity disorder,
generalized anxiety disorder, bipolar disorder, binge-eating disorder, and conversion disorder.
R.8-2, PageID 51.

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The Social Security Administration (SSA) Appeals Council declined to review the ALJ’s
decision. LaPlante then filed this action against the Commissioner of Social Security. A
magistrate judge issued a report and recommendation (R&R) that the district court affirm the
ALJ’s decision. LaPlante objected to the magistrate judge’s report and recommendation, and the
district court adopted the R&R and affirmed the ALJ’s decision.
This appeal followed.
II.
Our review of the ALJ’s decision is “limited to determining whether it is supported by
substantial evidence and was made pursuant to proper legal standards.” Rogers v. Comm’r of Soc.
Sec., 486 F.3d 234, 241 (6th Cir. 2007).
A.
LaPlante argues that the ALJ erred at Step Three by failing to address whether her
pseudoseizures were medically equivalent to Listing 11.02, epilepsy. This alleged failure is
significant because if the ALJ found that LaPlante’s impairments met or were medically equivalent
to one of the listings, LaPlante would be deemed disabled without moving on to the next steps. 20
C.F.R. § 404.1520(a)(4)(iii).
The Commissioner argues that LaPlante waived this argument by failing to include it in
her objections to the magistrate judge’s report and recommendation. But the argument lacks merit
in any event.
An impairment is medically equivalent to a listed impairment in appendix 1 if “it is at least
equal in severity and duration to” the impairment’s criteria. 20 C.F.R. § 404.1526(a). The SSA
“can find” equivalence in one of two ways. First, if a claimant has “an impairment that is described
in appendix 1,” the SSA will “find that [the] impairment is medically equivalent to that listing if

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you have other findings related to your impairment that are at least of equal medical significance
to the required criteria.” Id. § 404.1526(b)(1). Second, if a claimant’s impairment is not described
in appendix 1, or if the claimant has “a combination of impairments, none of which meets a listing”
in appendix 1, the SSA “will compare [the] findings with those for closely analogous listed
impairments.” Id. § 404.1526(b)(2)–(3).
LaPlante argues that the ALJ erred in failing to analyze whether her pseudoseizures were
medically equivalent to Listing 11.02, epilepsy. The SSA first asks whether a claimant has “an
impairment that is described in appendix 1.” 20 C.F.R. § 404.1526(b)(1). Pseudoseizures are;
they are described under Listing 12.07, somatic symptom and related disorders. See 20 C.F.R. pt.
404, app. 1, Listing 12.07. Thus, the SSA regulations ask whether, if Listing 12.07 is not
technically met, the claimant’s symptoms are nonetheless medically equivalent in severity and
duration to each of Listing 12.07’s criteria. LaPlante instead wants the ALJ to look to a different
listing, Listing 11.02. But that listing is clear that the SSA “evaluate[s] psychogenic seizures and
pseudoseizures under the mental disorders body system, 12.00.” 20 C.F.R. pt. 404, app. 1,
11.00H1. Thus—unlike disorders that are not listed—pseudoseizures are properly evaluated for
medical equivalence under the listings corresponding to mental disorders. Contra, e.g., Snyder v.
Comm’r of Soc. Sec., No. 22-5948, 2023 WL 3673265, at *3 (6th Cir. May 26, 2023) (noting that
primary headache disorders are not listed in appendix 1 and thus identifying “closely analogous
listed impairment[s]”).
LaPlante’s argument that the ALJ was required to consider whether her pseudoseizures
were equivalent to epileptic seizures contravenes the SSA’s regulations. Accordingly, we
conclude that the ALJ did not err in declining to consider LaPlante’s pseudoseizures for medical
equivalence to Listing 11.02.

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B.
LaPlante also argues that the ALJ improperly evaluated and weighed the evidence of her
pseudoseizures. We conclude that the ALJ erred by failing to articulate her reasons for the weight
given to LaPlante’s alleged symptoms, and remand to provide the ALJ an opportunity to explain
her reasoning.
In assessing the severity of the pseudoseizures, the ALJ stated that LaPlante “reported
seizures every other week, as well as migraine headaches,” but concluded, in just one sentence,
“that the evidence in the file is not consistent with disabling symptoms from these impairments.”
R.8-2, PageID 61. But “it is not sufficient for our adjudicators to make a single, conclusory
statement that ‘the individual’s statements about his or her symptoms have been considered’ or
that ‘the statements about the individual’s symptoms are (or are not) supported or consistent.'”
Soc. Sec. Ruling 16-3P, 2017 WL 5180304, at *10 (Oct. 25, 2017). The “decision must contain
specific reasons for the weight given to the individual’s symptoms . . . and be clearly articulated
so the individual and any subsequent reviewer can assess how the adjudicator evaluated the
individual’s symptoms.” Id. The ALJ’s brief discussion of LaPlante’s pseudoseizures, which gave
little weight to LaPlante’s alleged symptoms without any clear explanation, fails to do so.
The Commissioner argues that substantial evidence nonetheless supports the ALJ’s
disability determination. But even if “substantial evidence otherwise supports the decision,”
remand is required because “the agency failed to follow its own procedural regulation.” Wilson v.
Comm’r Soc. Sec., 378 F.3d 541, 544 (6th Cir. 2004); see also Miller v. Comm’r of Soc. Sec., 811
F.3d 825, 833 (6th Cir. 2016) (“Where, however, an ALJ fails to follow agency rules and
regulations, we find a lack of substantial evidence, ‘even where the conclusion of the ALJ may be
justified based upon the record.’” (citation omitted)); Hurst v. Sec’y of Health & Hum. Servs., 753

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F.2d 517, 519 (6th Cir. 1985) (“It is more than merely ‘helpful’ for the ALJ to articulate
reasons . . . for crediting or rejecting particular sources of evidence. It is absolutely essential for
meaningful appellate review.” (internal quotation marks and citation omitted)). So while the
Commissioner may be correct that the ALJ’s decision was supported by substantial evidence, we
require the ALJ to state her reasoning with more detail to allow a reviewing court to make that
determination.
III.
In sum, the ALJ did not err in declining to evaluate LaPlante’s pseudoseizures under the
epilepsy listing. However, the ALJ failed to properly articulate her evaluation of LaPlante’s
alleged symptoms. We accordingly AFFIRM in part and REVERSE in part, and REMAND for
further proceedings consistent with this opinion.

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