# SIKORA

> District Court, W.D. Pennsylvania · December 29, 2025

URL: https://www.frixlaw.com/law-library/cases/11232836

## Case

- **Full name:** Gail Sikora v. Frank Bisignano, Commissioner of Social Security
- **Court:** District Court, W.D. Pennsylvania
- **Decided:** December 29, 2025
- **Opinion:** 100trialcourt
- **Cited by:** 0 later opinions in the Frix Law Library

## Citator (automated)

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## How later opinions describe it (automated extraction)

- stating that the court has plenary review of all legal issues and reviews the ALJ’s findings of fact to determine whether they are supported by substantial evidence

## Opinion text

IN THE UNITED STATES DISTRICT COURT
FOR THE WESTERN DISTRICT OF PENNSYLVANIA

GAIL SIKORA, )
)
Plaintiff, ) Civil Action No. 3:24-cv-290
)
v. ) Magistrate Judge Maureen P. Kelly
)
FRANK BISIGNANO,1 ) Re: ECF Nos. 10 and 12
Commissioner of Social Security, )
)
Defendant. )

O R D E R

Pending before the Court are Plaintiff’s Motion for Summary Judgment and Brief in
Support thereof, ECF Nos. 10 and 11, and Defendant’s Motion for Summary Judgment and Brief
in Support thereof, ECF Nos. 12 and 13. Plaintiff has also filed a Reply Brief. ECF No. 15.2
Upon consideration of the parties’ cross-motions for summary judgment, and after
reviewing the final decision of the Commissioner of Social Security (“Commissioner”) denying
Plaintiff’s claim for supplemental security income (“SSI”) under Subchapter XVI of the Social
Security Act, 42 U.S.C. § 1381 et seq., the Court finds that the Commissioner’s findings are
supported by substantial evidence and, accordingly, affirms. See 42 U.S.C. § 405(g); Biestek v.
Berryhill, 587 U.S. 97, 102-03 (2019); Jesurum v. Sec’y of U.S. Dep’t of Health & Human
Servs, 48 F.3d 114, 117 (3d Cir. 1995) (citing Brown v. Bowen, 845 F.2d 1211, 1213 (3d Cir.

1 Frank Bisignano is substituted as the defendant in this matter pursuant to Federal Rule of
Civil Procedure 25(d) and 42 U.S.C. § 405(g).

2 Pursuant to 28 U.S.C. § 636(c), the parties have consented to the jurisdiction of a United
States Magistrate Judge to conduct all proceedings in this case, including trial and entry of final
judgment, with direct review by the United States Court of Appeals for the Third Circuit if an
appeal is filed. ECF No. 7.
1988)). See also Berry v. Sullivan, 738 F. Supp. 942, 944 (W.D. Pa. 1990) (if supported by
substantial evidence, the Commissioner’s decision must be affirmed, as a federal court may
neither reweigh the evidence, nor reverse, merely because it would have decided the claim
differently) (citing Cotter v. Harris, 642 F.2d 700, 705 (3d Cir. 1981)).
I. BACKGROUND

Plaintiff Gail Sikora (“Plaintiff”) protectively filed a claim for SSI effective November 3,
2020, claiming that she became disabled on March 1, 2016. AR at 25, 488-94.3 After being
denied initially on February 25, 2021, and upon reconsideration on November 23, 2021, Plaintiff
sought, and obtained, a hearing before an Administrative Law Judge (“ALJ”) on June 15, 2023.
AR at 25, 320-27, 334-43, 344, 100-167. At the June 15 hearing, in addition to taking the
testimony of Plaintiff and a vocational expert, the ALJ granted Plaintiff’s request to order both a
medical and a psychological consultative examination. AR at 162-63. After these examinations,
a supplemental hearing was held on November 17, 2023. AR at 58-99. In a thorough decision
dated December 18, 2023, the ALJ denied Plaintiff’s request for benefits, finding that she was

able to perform jobs that exist in significant numbers in the national economy. AR at 25-50. On
October 7, 2024, the Appeals Council declined to review the decision. AR at 1-3. Plaintiff filed
an appeal with this Court, and the parties have filed cross-motions for summary judgment.
On appeal, Plaintiff argues that the ALJ failed to properly consider whether her case met
the requirements for a listed impairment, that the ALJ failed to adequately develop the record
and abused her discretion in failing to order an additional consultative examination or submit the
case to a medical expert, and that she improperly applied the age criteria in the medical-
vocational guidelines. As discussed herein, the Court disagrees and finds that substantial

3 The Court will refer to the Administrative Record as “AR.”
evidence supports the ALJ’s decision that Plaintiff is not disabled. Indeed, the ALJ’s decision in
this matter was uniquely thorough and well-reasoned and needs little more support from this
Court.
II. STANDARD OF REVIEW
Judicial review of a social security case is based upon the pleadings and the transcript of

the record, and the scope of that review is limited to determining whether the Commissioner
applied the correct legal standards and whether the record, as a whole, contains substantial
evidence to support the Commissioner’s findings of fact. See 42 U.S.C. § 405(g); Schaudeck v.
Comm’r of Soc. Sec. Admin., 181 F.3d 429, 431 (3d Cir. 1999) (stating that the court has
plenary review of all legal issues and reviews the ALJ’s findings of fact to determine whether
they are supported by substantial evidence); Matthews v. Apfel, 239 F.3d 589, 592 (3d Cir.
2001). If the district court finds this to be so, it must uphold the Commissioner’s final decision.
See Rutherford v. Barnhart, 399 F.3d 546, 552 (3d Cir. 2005).
The Social Security Administration (“SSA”) has promulgated regulations incorporating a

five-step sequential evaluation process to guide ALJs in determining whether a claimant is under
a disability as defined by the Social Security Act. See 20 C.F.R. § 416.920. At Step One, the
ALJ must determine whether the claimant is currently engaging in substantial gainful activity. If
he or she is not engaging in such activity, at Step Two, the ALJ determines whether the claimant
is suffering from one or more severe impairments. If so, the ALJ proceeds to Step Three to
determine whether the claimant’s impairments meet or equal the criteria for a listed impairment.
If a claimant satisfies a listing, a finding of disability is automatically directed. If the claimant
does not satisfy a listing, the analysis proceeds to Steps Four and Five.
In considering these steps, the ALJ must formulate the claimant’s residual functional
capacity (“RFC”), which is defined as the most that an individual is still able to do despite the
limitations caused by his or her impairments. See Fargnoli v. Massanari, 247 F.3d 34, 40 (3d
Cir. 2001); 20 C.F.R. § 416.945(a)(1). At Step Four, it is the claimant’s burden to demonstrate
an inability to perform his or her past relevant work. If the ALJ determines that the claimant

lacks the RFC to resume his or her former occupation, the evaluation then moves to Step Five.
At this stage, the burden of production shifts to the Commissioner, who must demonstrate that
the claimant is capable of performing other available work in the national economy in order to
deny a claim of disability.
III. DISCUSSION
Here, the ALJ determined that Plaintiff was not disabled after applying the five-step
process. Specifically, she found that although Plaintiff suffered from several severe
impairments, none met or equaled a Listing, including Listings 12.04, 12.06, and 12.15. AR at
31-33. After formulating Plaintiff’s RFC, the ALJ found that Plaintiff was not disabled because

she was capable of performing other work in the national economy. AR at 48-49. As noted
above, Plaintiff raises several challenges to these findings.
A. Whether Plaintiff’s Mental Impairments Met a Listing
Plaintiff first argues that the ALJ inappropriately “impos[ed] requirements beyond what
is written in the regulations” in finding that her mental severe impairments did not meet a Listing
at Step Three of the sequential process. ECF No. 11 at 9. She further argues that ample
evidence existed in her file that would demonstrate that she met Listings 12.04, 12.06, and 12.15.
Id. at 14-16. For the reasons that follow, the Court disagrees.
As noted above, at Step Three an ALJ must determine whether a claimant’s impairments
meet or equal the criteria for a listed impairment as set forth in 20 C.F.R. Part 404, Subpart P,
Appendix 1. To meet a Listing, a claimant must “present medical findings equal in severity to
all the criteria of a listed impairment.” Degenaro-Huber v. Comm’r of Soc. Sec., 533 F. App’x
73, 75 (3d Cir. 2013) (quoting Sullivan v. Zebley, 493 U.S. 521, 531 (1990) (emphasis in

original)).
The Listings relevant here – 12.04, 12.06, and 12.15 – all pertain to mental disorders,
specifically depressive/bipolar and related disorders, anxiety and obsessive-compulsive
disorders, and trauma and stressor-related disorders. Each requires the claimant to satisfy either
(1) both the criteria in paragraph A and in paragraph B of the Listing or (2) the criteria in
paragraph C of the Listing. The language setting forth the paragraph C criteria is identical for
these three Listings:
C. Your mental disorder in this listing category is “serious and
persistent;” that is, you have a medically documented history
of the existence of the disorder over a period of at least 2
years, and there is evidence of both:

1. Medical treatment, mental health therapy, psychosocial
support(s), or a highly structured setting(s) that is ongoing
and that diminishes the symptoms and signs of your mental
disorder (see 12.00G2b); and

2. Marginal adjustment, that is, you have minimal capacity to
adapt to changes in your environment or to demands that
are not already part of your daily life (see 12.00G2c).

20 C.F.R. Part 404, Subpart P, App’x 1, 12.04C, 12.06C, 12.15C. Accordingly, to meet the
paragraph C criteria, a claimant’s condition must satisfy both part C.1 and part C.2. Here, the
ALJ found that Plaintiff’s conditions satisfied neither. AR at 32-33.4

4 Plaintiff does not allege that she meets the paragraph A and B criteria for these Listings.
While Plaintiff argues that the ALJ was wrong on both counts, the primary issue is
whether there was sufficient evidence of marginal adjustment pursuant to part C.2.5 The
regulations explain:
“Marginal adjustment” means that your adaptation to the
requirements of daily life is fragile; that is, you have minimal
capacity to adapt to changes in your environment or to demands
that are not already part of your daily life.

20 C.F.R. Part 404, Subpart P, App’x 1, 12.00G.2.c. Examples of this type of marginal
adjustment include an inability to function outside of the home or a more restrictive setting
without substantial psychosocial supports. See id. Such supports include
“the help of family members who aid a claimant in his or her basic
functioning and daily activities, participation in programs that
provide instruction in entry-level work skills and daily living, the
receipt of ‘comprehensive “24/7 wrap-around” mental health
services,’ residence in a hospital or institution that provides 24-
hour care, and receipt of ‘assistance from a crisis response team,
social workers, or community mental health workers’ who help the
claimant with his or her physical needs.”

Zook v. Comm’r of Soc. Sec., No. Civ. 23-1990, 2025 WL 564204, at *1 n.1 (W.D. Pa. Feb. 20,
2025) (quoting Gibson v. Saul, No. 20-145, 2021 WL 371577, at *5 (D. Conn. Feb. 3, 2021) (in
turn quoting 20 C.F.R. Part 404, Subpart P, App’x. 1, 12.00D.1.)). Further, “[t]he regulations
also recognize that a claimant can meet [the Paragraph C Criteria] if he [or she] lives alone and
does not receive psychosocial supports but has instead ‘created a highly structured environment
by eliminating all but minimally necessary contact with the world outside [his or her] living
space.’” Id. (quoting Gibson, 2021 WL 371577, at *5).

5 Because, as discussed herein, the Court finds that substantial evidence supports the ALJ’s
determination that there was a lack of evidence of marginal adjustment under part C.2, it need
not consider whether the ALJ’s decision that there was also insufficient evidence to satisfy part
C.1 was adequately supported.
As the ALJ thoroughly discussed, the evidence here demonstrates nothing of the sort.
The ALJ explained this by citing to largely normal mental status examinations that indicated
Plaintiff was doing well, was independent with activities of daily living, and was concerned
largely with situational stressors. AR at 32. For example, the ALJ referenced the July 13, 2023
consultative examination where Plaintiff indicated that she did not need help at home, drives,

cooks, does laundry, and shops twice a week. AR at 32, 1611-12. The ALJ further discussed
Plaintiff’s relatively conservative treatment history, her activities of daily living, and the fact that
she does not have the regular assistance of a blended case manager or case worker. Id. at 32-33.
Moreover, the ALJ found partially persuasive the findings of the state agency psychologists, both
of whom opined that the evidence did not establish the presence of the paragraph C criteria. AR
at 41-42, 46, 256, 280. This constitutes more than substantial evidence in support of her finding
that Plaintiff did not satisfy the part C.2 criteria.6
Plaintiff suggests that treatment records from the Billings Clinic, generated in 2017 while
she was living in Montana, AR at 678-748, provide the necessary evidence of her marginal
adjustment. ECF No. 11 at 14-15.7 However, these records still do not demonstrate the type of

extensive and comprehensive psychosocial supports or high degree of structure needed to satisfy

6 Plaintiff misleadingly implies that such an ability to independently perform daily tasks is
insufficient to support the ALJ’s findings because it sheds no light on her ability to adjust to the
requirements of competitive employment. ECF No. 11 at 13. In support of this proposition, she
cites to Social Security Ruling (S.S.R.) 96-8p, 1996 WL 374184 (S.S.A. July 2, 1996), and
S.S.R. 16-3p, 2017 WL 5180304 (S.S.A. Oct. 25, 2017), as well as cases such as Jesurum and
Fargnoli. ECF No. 11 at 13. However, these rulings and cases indicate merely that sporadic and
transitory activities cannot be used to show an ability to engage in substantial gainful activity.
See, e.g., Fargnoli, 247 F.3d at 40 n.5 (citing Jesurum, 48 F.3d at 119). The determination in
regard to the part C.2 criteria is not whether the claimant is able to engage in sustained gainful
activity, but whether the evidence shows that she has minimal capacity to adapt to changes in
her environment or to demands that are not already part of her daily life.

7 As Plaintiff acknowledges, the ALJ found these records to be cumulative and of little
relevance. AR at 148.
the part C.2 criteria. Moreover, the records were from approximately three years before the
application date and were considered as part of a previous application for benefits made by
Plaintiff.8
Although the ALJ may consider evidence introduced in a prior claim before the alleged
onset date, “the ALJ is not obligated find evidence prior to the onset date to be relevant or

probative.” McKean v. Colvin, 150 F. Supp. 3d 406, 414 (M.D. Pa. 2015) (citing Giese v.
Comm’r of Soc. Sec., 251 F. App’x 799, 804 (3d Cir. 2007)). Generally, evidence from outside
the relevant time period is probative only so far as it pertains to a claimant’s condition during the
relevant period. See Ortega v. Comm’r of Soc. Sec., 232 F. App’x 194, 197 (3d Cir. 2007); Hill
v. Colvin, No. 14-922, 2015 WL 5709028, at *3 (W.D. Pa. Sept. 28, 2015). The ALJ here found
this dated evidence to be, at best, cumulative of the other evidence that failed to demonstrate
satisfaction of the paragraph C criteria. The Court finds no fault in such a determination.
In sum, the record contains more than sufficient evidence to support the ALJ’s finding
that Plaintiff’s mental impairments do not satisfy the requirements of part C.2. See Hirst v.

Kijakazi, No. 20-1756, 2021 WL 5989111, at *4 (W.D. Pa. Dec. 17, 2021) (stating that “a
claimant who functions mostly independently, travels independently, shops alone, goes online,
manages money, and is observed to have goal-directed thoughts, typically cannot meet this
standard”). To the extent Plaintiff is asking the Court to re-weigh the evidence so as to come to
its own conclusion, it declines to do so, because if supported by substantial evidence, the
Commissioner’s decision must be affirmed, as a federal court may neither reweigh the evidence
nor reverse merely because it would have decided the claim differently. See Hartranft v. Apfel,

8 Although Plaintiff asserts an onset date of March 1, 2016, a claimant’s eligibility for SSI
benefits does not begin until he or she has filed an application. 20 C.F.R. §§ 416.202(g), 305(a);
see also Dunson v. Comm’r of Soc. Sec., 615 F. App’x 65, 67 n.1 (3d Cir. 2015); Heather M. v.
Dudek, No. CV 23-2239, 2025 WL 834750, at *1 n.3 (E.D. Pa. Mar. 17, 2025).
181 F.3d 358, 360 (3d Cir. 1999) (citing 42 U.S.C. § 405(g)); Monsour Med. Ctr. v. Heckler, 806
F.2d 1185, 1190-91 (3d Cir. 1986); Berry, 738 F. Supp. at 944 (citing Cotter, 642 F.2d at 705).
The Court therefore finds that substantial evidence supports the ALJ’s determination that
Plaintiff’s impairments did not meet the requirement of any Listing.
B. Whether the ALJ Adequately Developed the Record

Plaintiff next asserts that the ALJ did not satisfy her duty to develop the administrative
record because she declined to order additional consultative examinations and/or a medical
expert. Given the significant discretion afforded to ALJs in making such decisions, and in light
of the facts demonstrating that the ALJ was more than accommodating to Plaintiff’s requests, the
Court finds no merit in this argument.
Plaintiff is correct, of course, that an ALJ has a duty to develop a full and fair record in a
social security case. See Ventura v. Shalala, 55 F.3d 900, 902 (3d Cir. 1995); Carmichael v.
Barnhart, 104 F. App’x 803, 805 (3d Cir. 2004); 20 C.F.R. § 416.912(b)(1). It does, however,
remain Plaintiff’s burden to supply evidence in support of her claim. See Ventura, 55 F.3d at

902; Money v. Barnhart, 91 F. App’x 210, 215 (3d Cir. 2004) (citing Bowen v. Yuckert, 482
U.S. 137, 146 n.5 (1987)); Hess v. Sec’y of Health, Educ., and Welfare, 497 F.2d 837, 840 (3d
Cir. 1974). What the ALJ is required to do is “ensure that the claimant’s complete medical
history is developed on the record before finding that the claimant is not disabled.” Money, 91
F. App’x at 215. Under the circumstances, it is not clear what else the ALJ could have done to
help Plaintiff, who was represented throughout the administrative proceedings, obtain additional
relevant evidence.
Indeed, the record paints the picture of a patient ALJ doing her best to develop the record
despite constant demands and little actual help from Plaintiff or her counsel. At the first
administrative hearing, Plaintiff’s counsel requested that the ALJ order additional consultative
examinations or secure the assistance of a medical expert, in part to address the applicability of
the paragraph C criteria. AR at 109. The ALJ asked Plaintiff’s counsel if he had requested
opinion evidence from Plaintiff’s treating providers that would address these factors. AR at 113.
Counsel replied that he had not because treating physicians often do not want to provide such

opinions. Id. At the conclusion of the particularly lengthy hearing, the ALJ denied the request
for a medical expert but granted Plaintiff’s request for additional consultative examinations. AR
at 162-63.
Two consultative examinations, one mental and one physical, were conducted in July of
2023. AR at 1610-54. Afterward, in November of 2023, the ALJ conducted a second
administrative hearing to account for this new evidence. At the second hearing, Plaintiff’s
counsel requested that the ALJ order yet another consultative examination, a medical expert, or
medical interrogatories to address the applicability of the paragraph C criteria, which the ALJ
declined. AR at 74-77. She did, however, again provide Plaintiff with the opportunity to present

opinion evidence as to whether she demonstrated marginal ability to adjust. AR at 76.
Plaintiff’s counsel responded that he did not believe such evidence would be fairly considered by
the ALJ. Id.
Therefore, the ALJ did order two consultative examinations upon Plaintiff’s request and
consistently offered Plaintiff the opportunity to submit relevant expert evidence of her own. The
ALJ also accepted evidence not timely submitted by Plaintiff, AR at 26, and conducted two very
thorough hearings. It was only during the final hearing that the ALJ declined to order any
additional consultative examinations or medical experts. She explained that there was little more
than Plaintiff’s hope that such evidence would prove valuable and that the record already
contained ample evidence to reach a decision. Id. She also reiterated that Plaintiff’s counsel had
been given several opportunities to submit a medical source statement or additional records and
evaluations but had not done so. Id.
Plaintiff believes that this decision prevented the full development of the record. However,
while an ALJ may order a consultative examination to resolve an inconsistency or if the record is

insufficient to render a decision, he or she is generally not required to do so. See 20 C.F.R. §§
419.919a, 416.920b; Thompson v. Halter, 45 F. App’x 146, 149 (3d Cir. 2002). Generally, an ALJ
is authorized to obtain a consultative examination “if the information needed to make a disability
determination, ‘such as clinical findings, laboratory tests, a diagnosis or a prognosis’ cannot be
obtained from the claimant’s medical sources.” Tuulaupua v. Colvin, Civ. No. 14-1121, 2015 WL
5769984, at *6 (W.D. Pa. Sept. 30, 2015) (emphasis in original) (quoting 20 C.F.R. §§
404.1519a(a) and (b)). Such an examination may be ordered “to try to resolve an inconsistency in
the evidence or when the evidence as a whole is insufficient to support a determination or decision
on [the claimant’s] claim.” 20 C.F.R. § 416.919a(b). The decision whether to order such an

examination is within the sound discretion of the ALJ. See Thompson, 45 F. App’x at 149. This
decision “should be firmly rooted in an assessment of the evidence as a whole.” Woodman v.
Berryhill, No. 3:17-cv-151, 2018 WL 1056401, at *5 (M.D. Pa. Jan. 30, 2018).
Likewise, “Social Security regulations permit – but do not require – an ALJ to ask for
and consider opinions from medical experts on the nature and severity of a claimant’s
impairment(s), and whether they equal the requirements of a listed impairment.” Hardee v.
Comm’r of Soc. Sec., 188 F. App’x 127, 129 (3d Cir. 2006) (internal citations omitted). An ALJ
similarly has broad discretion in determining whether to consult with a medical expert.9 See id.
See generally 20 C.F.R. § 416.929(b).
Given the significant discretion afforded to ALJs in determining whether to order a
consultative examination or obtain the services of a medical expert, the facts here come nowhere
close to establishing any abuse of such discretion. The record in this case was already extensive

and certainly contained sufficient evidence for the ALJ to render a decision. Further, as
discussed, the ALJ did, in fact, order two consultative examinations after the first administrative
hearing at Plaintiff’s request; she only refused when Plaintiff continued to ask even after those
examinations had been conducted. The ALJ was lenient in admitting evidence and provided
Plaintiff with two lengthy administrative hearings.
The ALJ also repeatedly provided Plaintiff with the opportunity to present any evidence
she wished to, opinion or otherwise, that might relate to the paragraph C criteria. Plaintiff’s
counsel’s responses as to why he declined to do so make little sense. First, contrary to his
apparent experience, opinions from treating physicians are common in social security cases, and

the SSA regulations have always assumed that such opinions would regularly be part of the
administrative record. Moreover, counsel’s assumption that the ALJ would not treat opinion
evidence submitted by Plaintiff fairly, despite the fact that the ALJ expressly invited such
evidence, is not based on any record evidence.

9 Despite this discretion, an ALJ is obligated to seek a medical expert's opinion in three
instances: (1) when the Appeals Council or a court so orders; (2) to evaluate and interpret
background medical test data; and (3) when an ALJ “is considering a finding that the claimant’s
impairment(s) medically equals a medical listing.” Cooper v. Comm’r of Soc. Sec., 563 F.
App’x 904, 910 (3d Cir. 2014) (emphasis added). None of these three situations are in play here;
the ALJ was not considering whether any of Plaintiff’s mental impairments medically equaled a
Listing.
Accordingly, the Court finds that the ALJ acted well within her broad discretion in
declining to order additional consultative examinations and/or medical experts. See Twila H. v.
Comm’r of Soc. Sec., No. CV 24-586, 2025 WL 875796, at *8 (E.D. Pa. Mar. 19, 2025).
C. Consideration of Plaintiff’s Borderline Age Status
Plaintiff’s final argument is that the ALJ committed reversible error by “mechanically”

applying the age criteria of the medical-vocational guideline section of the regulations
(commonly referred to as the “Grids”), 20 C.F.R., Part 404, Subpart P, Appendix 2, despite
Plaintiff’s borderline age situation. Plaintiff asserts that since she was within 5 months of
turning 55, the ALJ should have considered applying the next higher age category (which begins
at age 55) under the Grids. Plaintiff contends that doing so would have resulted in a finding of
“disabled” under the Grids based on her limitation to unskilled light work. ECF No. 11 at 19-20.
However, contrary to Plaintiff’s claims, the ALJ did not “mechanically” apply the Grids but
rather thoroughly considered Plaintiff’s borderline age status in deciding whether she could
perform work sufficient to satisfy Step Five of the sequential process.

The Grids assist ALJs in deciding whether a claimant is disabled by directing a finding of
“disabled” or “not disabled” based on the combination of various considerations, including the
claimant’s physical abilities, age, education, and work experience. Sykes v. Apfel, 228 F.3d 259,
266-67 (3d Cir. 2000) (citing 20 C.F.R., Part 404, Subpart P, App’x 2). However, where a
claimant has non-exertional limitations as well as exertional ones, an ALJ cannot rely solely on
the Grids to make his or her disability finding. See id. at 267. Additionally, the ALJ “will not
apply the age categories mechanically in a borderline situation.” 20 C.F.R. § 416.963(b).
Rather, if a claimant is “within a few days to a few months of reaching an older age category,
and using the older age category would result in a determination or decision that [the claimant is]
disabled, [the ALJ] will consider whether to use the older age category after evaluating the
overall impact of all the factors of [the claimant's] case.” Id. Therefore, in borderline situations,
the ALJ “cannot mechanically apply the Grids' age categories, but must ‘give full consideration
to all relevant facts.’” Lucas v. Barnhart, 184 F. App’x 204, 206 (3d Cir. 2006) (quoting Kane v.
Heckler, 776 F.2d 1130, 1133-34 (3d Cir. 1985)).

The ALJ did precisely that here. She did not simply use the age category that applied to
Plaintiff but considered at length whether the fact that she was within a “few” months of attaining
the next older age category warranted the application of the higher category. AR at 48. She
explained that use of the next category was “not supported by the limited adverse impact of all
factors on the claimant’s ability to adjust to other work.” Id. The ALJ considered that Plaintiff
did not have a lowered educational level and that her past work as a bartender, stock clerk, and
geriatric nurse assistant was not in an isolated industry. Id. She also emphasized that Plaintiff’s
counsel had been provided with the opportunity to justify the use of the higher age category but
failed to do so. Id. Further, the ALJ did not rely directly on the Grids but rather relied on the

findings of the vocational expert who had found, based on Plaintiff’s RFC, that she could perform
the jobs of mail sorter, office helper, and lamination machine operator. Id. at 48-49.
This analysis is precisely what the ALJ was required to do; she was not compelled to
automatically apply the next older age category merely because of Plaintiff’s arguable borderline
age status. The rationale she provided for declining to do so is consistent with reasoning the
United States Court of Appeals for the Third Circuit has found adequate in borderline age
situations. See Roberts v. Barnhart, 139 F. App’x 418 (3d Cir. 2005) (holding that the ALJ
appropriately declined to apply the next age category where the claimant was 5-6 months short
of the next relevant birthday and where the ALJ did not merely apply the Grids but consulted a
vocational expert because the claimant could not perform a full range of light work). See also
Holland v. Comm’r of Soc. Sec., No. Civ. 10-1019, 2012 WL 11052, at *1 n.1 (W.D. Pa. Jan. 3,
2012).
Therefore, the Court finds that the ALJ properly considered Plaintiff’s borderline age
status and that substantial evidence supports her decision not to apply the next higher age

category.
IV. CONCLUSION
Accordingly, for all of the foregoing reasons, the Court finds that the ALJ applied the
correct legal standards and that substantial evidence supports her decision. It will therefore
affirm.
AND NOW, this 29th day of December 2025, IT IS HEREBY ORDERED that Plaintiff’s
Motion for Summary Judgment, ECF No. 10, is DENIED and that Defendant’s Motion for
Summary Judgment, ECF No. 12, is GRANTED.
IT IS FURTHER ORDERED that, pursuant to Rule 4(a)(1) of the Federal Rules of

Appellate Procedure, if any party wishes to appeal from this Order, he or she must do so within
thirty (30) days by filing a notice of appeal as provided in Rule 3, Fed. R. App. P., with the Clerk
of Court, United States District Court.

Respectfully submitted,

s/ Maureen P. Kelly
MAUREEN P. KELLY
UNITED STATES MAGISTRATE JUDGE

cc: All counsel of record via CM/ECF

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Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/11232836. Public record. Not legal advice.