The opinion
IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF NORTH CAROLINA
ELBA R., )
)
Plaintiff, )
)
v. ) 1:25CV192
)
FRANK BISIGNANO, )
Commissioner of Social Secutity,! )
)
Defendant. )
MEMORANDUM OPINION AND ORDER
OF UNITED STATES MAGISTRATE JUDGE
Plaintiff Elba R. (‘Plaintiff’) brought this action pursuant to Section 205(g) of the
Social Security Act (the “Act’), as amended (42 U.S.C. § 405(g)), to obtain judicial review of a
final decision of the Commissioner of Social Security denying her claim for Disability
Insurance Benefits (“DIB”) under Title II of the Act. The parties have filed cross-motions
for judgment, and the administrative record has been certified to the Court for review.
I. PROCEDURAL HISTORY
Plaintiff protectively filed her application for DIB on February 21, 2022, alleging a
disability onset date of January 1, 2021. (Tr. at 1, 244-50.)? Plaintiffs application was denied
1 The United States Senate confirmed Frank Bisignano as the Commissioner of Social Security on May 6, 2025,
and he took the oath of office on May 7, 2025. Pursuant to Rule 25(d) of the Federal Rules of Civil Procedute,
Frank Bisignano should be substituted as the Defendant in this suit. Neither the Court nor the parties need
take any further action to continue this suit by reason of the last sentence of section 205(g) of the Social Security
Act, 42 U.S.C. § 405(2).
2 Transcript citations refer to the Sealed Administrative Record [Doc. #5].
initially (I'r. at 69-75, 90-101) and upon reconsideration (Tr. at 76-84, 103-110). Thereafter,
Plaintiff requested an administrative hearing de novo before an Administrative Law Judge
(“ALJ”). (Tr. at 111-12.) On September 13, 2023, Plaintiff, along with her attorney, attended
the subsequent video hearing, at which Plaintiff and an impartial vocational expert testified.
at 19, 41-68.) Following the hearing, the ALJ concluded that Plaintiff was not disabled
within the meaning of the Act (Tr. at 35), and on February 6, 2025, the Appeals Council denied
PlaintifPs request for review of that decision, thereby making the AL]’s conclusion the
Commissioner’s final decision for purposes of judicial review (Tr. at 1-8).
IL. LEGAL STANDARD
Federal law “authorizes judicial review of the Social Security Commissionet’s denial of
social security benefits.” Hines v. Barnhart, 453 F.3d 559, 561 (4th Cir. 2006). However, the
scope of review of such a decision is “extremely limited.” Frady v. Harris, 646 F.2d 143, 144
(4th Cir. 1981). “The courts are not to try the case de novo.” Oppenheim v. Finch, 495 F.2d
396, 397 (4th Cir. 1974). Instead, “a reviewing court must uphold the factual findings of the
ALJ if they ate supported by substantial evidence and were reached through application of the
cottect legal standard.” Hancock v. Astrue, 667 F.3d 470, 472 (4th Cir. 2012) (internal
quotation omitted).
“Substantial evidence means ‘such relevant evidence as a reasonable mind might accept
as adequate to support a conclusion.” Hunter v. Sullivan, 993 F.2d 31, 34 (4th Cir. 1993)
(quoting Richardson v. Perales, 402 U.S. 389, 390 (1971)). “It consists of more than a mete
scintilla of evidence but may be somewhat less than a preponderance.” Mastro v. Apfel, 270
F.3d 171, 176 (4th Cir. 2001) (internal citations and quotation marks omitted). “If there is
evidence to justify a refusal to direct a verdict were the case before a jury, then there is
substantial evidence.” Hunter, 993 F.2d at 34 (internal quotation marks omitted).
“In reviewing for substantial evidence, the court should not undertake to re-weigh
conflicting evidence, make credibility determinations, or substitute its judgment for that of the
[ALJ].” Mastro, 270 F.3d at 176 (internal brackets and quotation marks omitted). “Where
conflicting evidence allows reasonable minds to differ as to whether a claimant is disabled, the
responsibility for that decision falls on the ALJ.” Hancock, 667 F.3d at 472. “The issue before
[the reviewing court], therefore, is not whether [the claimant] is disabled, but whether the
finding that [the claimant] is not disabled is supported by substantial evidence and was
reached based upon a correct application of the relevant law.” Craig v. Chater, 76 F.3d 585,
589 (4th Cir. 1996).
In undertaking this limited review, the Court notes that “[a] claimant for disability
benefits bears the burden of proving a disability.” Hall v. Harris, 658 F.2d 260, 264 (4th Cir.
1981). In this context, “disability” means the “‘tnability 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.” Id. (quoting 42 U.S.C. § 423(d)(1)(A)).3
3 “The Social Secutity Act comprises two disability benefits programs. The Social Secutity Disability Insurance
Program (SSDD), established by Title II of the Act as amended, 42 U.S.C. § 401 et seq., provides benefits to
disabled persons who have contributed to the program while employed. The Supplemental Security Income
Program (SSD), established by Title XVI of the Act as amended, 42 U.S.C. § 1381 et seq., provides benefits to
indigent disabled persons. The statutory definitions and the regulations promulgated by the Secretary for
determining disability, see 20 C.F.R. pt. 404 (SSDJ; 20 C.F-.R. pt. 416 (SSD), governing these two programs are,
in all aspects relevant here, substantively identical.” Craig, 76 F.3d at 589 n.1.
“The Commissioner uses a five-step process to evaluate disability claims.” Hancock,
667 F.3d at 472 (citing 20 C.F.R. §§ 404.1520(a)(4); 416.920(a)(4)). “Under this process, the
Commissioner asks, in sequence, whether the claimant: (1) worked during the alleged period
of disability; (2) had a severe impairment; (3) had an impairment that met or equaled the
requitements of a listed impairment; (4) could return to her past relevant work; and (5) if not,
could perform any other work in the national economy.” Id.
A finding adverse to the claimant at any of several points in this five-step sequence
fotecloses a disability designation and ends the inquity. For example, “[t]he first step
determines whether the claimant is engaged in ‘substantial gainful activity.’ If the claimant is
working, benefits are denied. The second step determines if the claimant is ‘severely’ disabled.
If not, benefits are denied.” Bennett v. Sullivan, 917 F.2d 157, 159 (4th Cir. 1990).
On the other hand, if a claimant carries his or her burden at the first two steps, and if
the claimant’s impairment meets or equals a “listed impairment” at step three, “the claimant
is disabled.” Mastro, 270 F.3d at 177. Alternatively, if a claimant clears steps one and two,
but falters at step three, i.e., “[i]f a claimant’s impairment is not sufficiently severe to equal or
exceed a listed impairment,” then “the AL] must assess the claimant’s residual functional
capacity (RFC?).” Id. at 179.4 Step four then requires the AL] to assess whether, based on
4 “REC is a measurement of the most a claimant can do despite [the claimant’s] limitations.” Hines, 453 F.3d
at 562 (noting that administrative regulations require RFC to reflect claimant’s “ability to do sustained work-
related physical and mental activities in a work setting on a regular and continuing basis . . . [which] means 8
hours a day, for 5 days a week, or an equivalent work schedule” (internal emphasis and quotation marks
omitted)). The RFC includes both a “physical exertional or strength limitation” that assesses the claimant’s
“ability to do sedentary, light, medium, heavy, or very heavy work,” as well as “nonexertional limitations
(mental, sensory, or skin impairments).” Hall, 658 F.2d at 265. “RFC is to be determined by the AL] only after
[the ALJ] considers all relevant evidence of a claimant’s impairments and any related symptoms (¢.g., paiti).”
Hines, 453 F.3d at 562-63.
that REC, the claimant can “perform past relevant work’; if so, the claimant does not qualify
as disabled. Id. at 179-80. However, if the claimant establishes an inability to return to prior
work, the analysis proceeds to the fifth step, which “requires the [Government] to prove that
a significant number of jobs exist which the claimant could perform, despite [the claimant’s]
impairments.” Hines, 453 F.3d at 563. In making this determination, the ALJ must decide
“whether the claimant is able to perform other work considering both [the claimant’s RFC]
and [the claimant’s] vocational capabilities (age, education, and past work experience) to adjust
to a new job.” Hall, 658 F.2d at 264-65. If, at this step, the Government cannot carty its
“evidentiary burden of proving that [the claimant] remains able to work other jobs available
in the community,” the claimant qualifies as disabled. Hines, 453 F.3d at 567.
Il. DISCUSSION
In the present case, the ALJ found that Plaintiff had not engaged in “substantial gainful
activity” since her alleged onset date. The ALJ therefore concluded that Plaintiff met her
burden at step one of the sequential evaluation process. (Tr. at 21-22.) At step two, the AL]
further determined that Plaintiff suffered from the following severe impairments:
[D]egenerative disc disease; psoriatic arthritis; chronic pain; migraines; obesity;
and major depressive disorder|.|
(Tr. at 22.) The ALJ found at step three that none of Plaintiffs impairments, individually or
in combination, met or equaled a disability listing. (I'r. at 23-26.) Therefore, the AL] assessed
PlaintifPs RFC and determined that she could perform light work with the following additional
limitations:
[Plaintiff] can lift and carry 20 pounds occasionally and 10 pounds frequently.
She can sit for six hours and stand and/or walk for six hours in an eight-hour
workday. She requites the option to alternate between sitting and standing at
15-minute intervals. [Plaintiff] can frequently balance, as that term is defined in
the Dictionary of Occupational Titles[,] and can occasionally stoop. She can
frequently kneel, crouch, crawl, and climb ramps and stairs but can never climb
ladders, ropes, or scaffolds. She must avoid concentrated exposure to moving
machinery, hazardous machinery, unprotected heights, and loud noise.
[Plaintiff] can understand, remember, and carry out simple instructions and can
have occasional interaction with the general public.
(Tr. at 26-27.) At step four of the analysis, the ALJ found, based on the vocational expett’s
testimony, that all of Plaintiffs past relevant work exceeded her RFC. (Tr. at 33.) However,
the AL) further determined at step five that, given Plaintiff's age, education, work experience,
REC, and the testimony of the vocational expert as to these factors, she could perform other
jobs available in significant numbers in the national economy. (Tr. at 33-34.) Therefore, the
ALJ concluded that Plaintiff was not disabled under the Act. (It. at 35.)
Plaintiff now contends that the ALJ failed to properly consider the effect of
absenteeism due to frequent medical treatment and migraines on Plaintiffs ability to work. As
set out above, the RFC measures a claimant’s ability to do sustained work-related physical and
mental activities in a work setting “on a regular and continuing basis,” 20 C.F.R. §§ 404.1545(b)
and (c) (emphasis added). This “‘means 8 hours a day, for 5 days a week, or an equivalent
wortk schedule,” Hines, 453 F.3d at 562 (emphasis omitted) (quoting Social Security Ruling
96-8p, Titles II and XVI: Assessing Residual Functional Capacity in Initial Claims, 1996 WL
374184, at *2 (July 2, 1996) (“SSR 96-8p”)). When making an RFC determination, the AL]
must take into consideration “[t]he effects of treatment, including limitations or restrictions
imposed by the mechanics of treatment (e.g., frequency of treatment, duration, disruption to
routine, side effects of medication).” SSR 96-8p, 1996 WL 374184, at *5. Accordingly,
“lalbsenteeism due to the frequency of treatment is a relevant factor so long as the treatment
is medically necessary and concerns the conditions on which the disability claim is founded.”
Griffin v. Commissioner of Soc. Sec., No. 2:15CV13715, 2017 WL 991006, at *2 (E.D. Mich.
Mar. 15, 2017).
In the present case, Plaintiffs attorney specifically argued in his closing before the ALJ
that Plaintiff's frequent absences for required medical treatment and migtaines formed the
ctux of her disability claim. (Tr. at 67.) The ALJ later included at least some discussion of
Plaintiffs migraines and their effect on her functioning in the administrative decision.
However, she omitted any reference to Plaintiff's extensive medical appointments throughout
the relevant time period at issue, and failed to address how these frequent appointments would
affect Plaintiffs ability to work. This failure requires remand.
As highlighted by Plaintiff in “an abridged summaty of [her] extensive physical
treatment,” the record shows that Plaintiff attended just shy of one hundted medical
appointments between her alleged onset date, January 1, 2021, and the date of het
administrative heating, September 13, 2023. (Pl.’s Br. [Doc. #11] at 6-16.) In other words,
Plaintiff averaged three medical appointments per month for treatment of her physical
impaitments during the alleged disability period. These appointments included testing and
treatment regarding a tumor/lesion on Plaintiffs spine, epidural steroid injections,
intramuscular Toradol injections, sacroiliac joint injections, and branch blocks for Plaintiffs
spine pain, physical and occupational therapy for Plaintiffs spine, and pain management
setvices, with records reflecting a history of spinal surgery and with MRIs reflecting “severe
facet atthtopathy with the intraforaminal disc herniation at L4-5 level along with translation
of the L5-S1 level laminectomy” (T'r. at 425), “[netve root] compression at L4, L5 and S1” (Tt.
at 379), and “collapse L4/5, possible start of bone bridging anteriorly . . . [s]ome deformity
tight L5/S1 lamina in area of prior laminectomy . . severe L4/5 facet [degenerative disc
disease]” (Tr. at 821) and recent surgical implantation of a spinal cord stimulator (Tr. at 1600).
These appointments also include regular rheumatology and pain management visits for
treatment of Plaintiffs psoriatic arthritis flares, including golimumab infusions and
“<mmunosupptessant medication that requires intensive monitoring” (Tr. at 834), with swollen
and painful joints in her hands. Moreover, this average of thtee appointments per month does
not include the additional treatment for Plaintiffs mental impairments, which began in January
2022 and took place approximately once a month. (Pl.’s Br. at 16-17.) Notably, the ALJ
categorized all of the impairments treated at these appointments, both physical and mental, as
“sevete” at step two of the sequential analysis, indicating that they were “conditions on which
[her] disability claim [was] founded.” (See Tr. at 22); Griffin, 2017 WL 991006, at *2.
Plaintiff further argues that the AL]’s failure to consider her need for frequent medical
treatment was harmful, given the testimony of the vocational expert regarding absenteeism.
Specifically, the following exchange occurred between Plaintiff's attorney and the expert near
the end the Plaintiffs hearing:
Q If the hypothetical individual, due to either some combination of
migraines ot frequent medical appointments, were regularly absent two or more
times pet month, would that affect any of the jobs that you cited?
A Yes. At the unskilled level, employers typically tolerate one absence per
month. Anything more than that would be work preclusive.
Q And at the semi-skilled level?
A Semi-skilled, I would assign a range of between one to two absences pet
month.
Q And so if there were absences of three ot more, thete would be no jobs?
A Correct.
(Tr. at 66-67.) Ultimately, the ALJ in this case failed to include any reference to this testimony
in her decision. In fact, she did not acknowledge Plaintiffs frequent medical treatment in any
way, let alone cite reasons for discounting the necessity of such treatment.
In a similar case, this Court remanded where the ALJ failed to address how ongoing
enzyme infusions to treat Gauchet’s Disease would impact Plaintiff's ability to work:
[I]n assessing Plaintiffs RFC, the ALJ did not consider effects of treatment,
including limitations or restrictions imposed by the mechanics of treatment
related to Plaintiff's bi-weekly infusions . . . as requited by SSR 96-8p, and did
not obtain evidence from the vocational expert regarding the availability of
employment in light of those limitations. Given the AL]’s failure to address or
consider this issue at all, substantial evidence fails to support the ALJ’s decision,
and remand is required to allow the ALJ to consider the effect of Plaintiffs
treatment on her ability to work.
Shoemaker v. Saul, No. 1:19CV441, 2020 WL 5117992, at *6 (M.D.N.C. Aug. 31, 2020)
(Peake, M.J.), recommendation adopted, slip op. (M.D.N.C. Sept. 15, 2020) (Schroeder, C,J.).
In that case, Defendant argued, in part, that medical appointments were not an appropriate
consideration for assessing a claimant’s RFC. Here, the Commissioner echoes that argument,
assetting that Plaintiff “has not shown her medical appointments actually would result in
absences ftom work.” (Def.’s Br. [Doc. #16] at 7.) The Commissioner further asserts that,
the ALJ is not bound by the number of medical appointments the claimant
attends during the petiod at issue when determining how frequently she would
be absent from work. Indeed, “i]f the sheer number of medical visits were
sufficient on its own, claimants could manufacture their own disabilities simply
by going to the doctor as often as possible for any or no reason.” Hoppa v.
Colvin, No. 12-CV-847-BBC, 2013 WL 5874639, at *5 (W.D. Wis. Oct. 31,
2013).
Other relevant considerations include whether the claimant’s appointments
were scheduled, whether the claimant would miss an entire day of work for each
appointment, and whether the claimant could schedule her appointments
outside of working houts. See, e.g., Best v. Berryhill, 730 F. App’x 380, 382 (7th
Cir. July 11, 2018) (rejecting claimant’s absenteeism argument as “frivolous”
because he failed to “point to anything in the record to suggest that his
appointments would require him to miss a full day of work or that he could not
schedule his appointments outside of working houts.”)[-|
(Def.’s Br. at 8-9.) However, as in Shoemaker, there is no evidence that the ALJ in the present
case considered these possibilities, let alone questioned Plaintiff about them or presented them
as hypothetical questions to the vocational expert at step five of the sequential analysis. See
Kim J.H. v. Saul, No. 18CV2736, 2020 WL 872308, at *11 (D. Minn. Jan. 28, 2020) (“It may
be that Plaintiff is not entitled to a period of closed disability for some or all of these 33
months, whether due to . . . an employet’s tolerance for full and half days, or some other
reason. Or, based on the record as a whole, it may be that Plaintiff would be absent from
wotk less than two days pet month, which the vocational expert testified would be tolerated
by an employer. These considerations, and the Commissionet’s arguments as to the precise
period of time in which Plaintiff may be eligible for disability benefits, are best addressed by
the ALJ and the vocational expert in the first instance. Considering the evidence in the record
tegatding the extent and frequency of Plaintiff's treatment, the ALJ must explain how this
coutse of treatment is reconcilable with the vocational expert’s testimony regarding tolerated
absences in a manner that allows the Court to determine whether the ALJ’s conclusion that
Plaintiff would not be absent two or more days pet month is supported by substantial evidence
in the tecord as a whole.” (internal citations omitted)). To undertake this analysis in the first
instance would usurp the ALJ’s role as fact finder. See Sec. & Exch. Comm’n v. Chenery
Corp., 318 U.S. 80, 87 (1943) (courts must teview administrative decisions on the grounds
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upon which the record discloses the action was based); Anderson v. Colvin, No. 1:10CV671,
2014 WL 1224726, at *1 (M.D.N.C. Mar. 25, 2014) (noting that this Court’s “[r]eview of the
ruling is limited further by the so-called ‘Chenery Doctrine,’ which prohibits courts from
considering post hoc tationalizations in defense of administrative agency decisions. Under the
doctrine, a reviewing court must judge the propriety of [agency] action solely by the grounds
invoked by the agency. If those grounds are inadequate or improper, the court is powerless to
affirm the administrative action by substituting what it considers to be a more adequate or
proper basis.” (quotations and citations omitted)).
The Fourth Circuit made a similar distinction in Meyer v. Astrue, 662 F.3d 700, 707
n.3 (4th Cir. 2011). There, the record indicated that the plaintiff attended more than 170 post-
sutgety physical therapy sessions during the relevant period, yet the ALJ failed to consider the
effect of this treatment on Plaintiffs RFC. The Fourth Circuit, “[flollowing the lead of the
Fifth Circuit in Newton v. Apfel, 209 F.3d 448, 459 (5th Cir. 2000), . . . instruct[ed] the
Commissioner on remand to ‘consider the effect of this ongoing treatment on [the plaintiffs]
ability to remain gainfully employed during the period of claimed disability.”” Meyer, 662 F.3d
at 707 n.3.
Mote recently, in Dennis v. Kijakazi, No. 21-2078, 2023 WL 2945903, at *1-2 (4th Cir.
Apr. 14, 2023), the Fourth Circuit addressed the impact of a less predictable treatment
schedule, noting that the plaintiff “was admitted four times out of her six ER visits, for a total
of 24 days (17 weekdays) in 2016 and 11 days (9 weekdays) in 2018” due to her impairments.
Ultimately, the court reached the same conclusion as in ongoing treatment cases. In all
instances, two factors remain paramount. First, ALJs must follow the directives of SSR 96-
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8p, which involves considering the effects of treatment, including its frequency, duration, and
its disrupting influence on a claimant’s routine. See SSR 96-8p, 1996 WL 374184, at *5.
Second, where such factors ate present in the record, AL]s must discuss the relevant evidence
in a way that permits meaningful judicial review. In Dennis, the Fourth Circuit concluded that
the AL]’s failure to discuss the record evidence regarding [the plaintiffs]
absenteeism results in [the court’s] inability to provide meaningful review. There
is evidence supporting [the plaintiff's] need to miss work in the administrative
record, and the ALJ’s decision does not discuss this evidence, nor does the
ALJ’s decision adequately explain why the evidence should be rejected. Indeed,
the ALJ did not offer any reasons for rejecting or discounting the frequency of
[the plaintiff's] medical treatment. Nowhere in the denial did the ALJ address:
(1) the frequency of [the plaintiff's] medical treatment, (2) how the frequency of
[the plaintifPs] medical treatment would impact absenteeism, or (3) how [the
plaintiff's] frequent medical treatment would impact the VE’s testimony that
missing mote than 7 to 10 days per yeat would be subject to firing. This was
error because [the court] can only guess why the ALJ failed to address the
obvious implications of [the plaintiff's] frequent medical treatment.
Dennis, 2023 WL 2945903, at *5 (internal quotation marks and parenthetical citation omitted).
Notably, in the present case, the Commissioner repeatedly stresses that Plaintiff
maintains the burden of ptoof regarding her RFC, including whether she could sustain full-
time work due to the frequency of her medical appointments. (Def.’s Br. at 11-12.) He
contends that Plaintiff “has not demonstrated that her medical appointments would consume
a full day ot could not be scheduled around work.” (Id. at 11.) This argument misses the
mark. As previously explained, Plaintiffs treatment record and her attorney’s arguments
clearly raised the issue of whether her frequency of treatment interfered with her ability to
perform full-time work. It may be that Plaintiff has not made a showing sufficient to prove
this. Again, the problem in this case, as in Shoemaker, Meyer, and Dennis, is that the
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administrative decision before the Court—the Court’s only basis for review—does not show
that the AL] considered the underlying evidence or its effect in the first instance.
Finally, Defendant asserts that “the record showed Plaintiff worked successfully for
many yeats despite frequently attending medical appointments.” (Def.’s Br at 10) (citing Tr. at
889) (“[Plaintiff] says 18 years ago she had back surgery and since that time she’s been coming
to the doctor for different therapies to help with pain. She spent many years going to the
doctor evety month and sometimes every week.”). The ALJ made no mention of this in her
decision, let alone indicated that she telied on it in discounting Plaintiffs allegations of
absenteeism. Moreover, Plaintiffs attorney specifically addressed the issue of past and
ongoing absences in the closing:
Your Honor, I believe what we have here is somebody with such severe
limitations that there would be frequent periods off-task and/or significant
absences. That is, in fact, what her employer has found. They ate a self-insured.
I think you see in the evidence, some statements from Clorox, which is the
patent company of Burt’s Bees. They ended up putting her out due to her
frequent absences and inability to maintain a schedule. And so I think we’re
looking at a 96-8p [situation], if not a medfical]-voc[ational one].
(Tr. at 67.) Eatnings records indicate that [Plaintiff] worked for the same employer, Butt’s
Bees, from 2003 until her alleged disability onset date of January 1, 2021. (Tr. at 280-83.)
Thus, the vast majority of the 18 years in question fell within Plaintiffs employment with
Burt’s Bees, yet her absences only reached a disabling level in 2021. In other words, evidence
of Plaintiffs long-term history of missing work for medical reasons supports, rather than
undermines, her atgument in the present case. Indeed, the record reflects that Burt’s Bees
concluded that Plaintiff was disabled in 2021, and Plaintiff testified at the hearing that she was
receiving disability benefits through Burt’s Bees (I't. at 59, 67, 255, 257-62, 360.)
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Where, as here, the record clearly raised the issue of work absences for medical
treatment, and Plaintiffs counsel specifically relied upon that issue at the heating as the basis
for finding disability, and Plaintiffs long-term employer apparently concluded that Plaintiff
was disabled for that very reason, the AL]’s failure to address the issue at all leaves the Court
without sufficient basis to follow the ALJ’s reasoning. Of course, as the Commissioner
suggests, there may be multiple reasons why this issue may not be work-preclusive. The AL]
could conclude that Plaintiffs medical treatment involves scheduled appointments that could
be scheduled outside of work hours, as the Commissioner suggests, and the ALJ could obtain
testimony from the vocational expert reflecting the job numbers for second or third shift or
the availability of weekend shifts that would leave weekdays free for scheduled appointments,
ot the ALJ could obtain testimony about the number of part-day absences allowed for medical
appointments. These ate all matters for the ALJ to consider in the first instance, and there is
no indication here that the ALJ considered or addressed the issue at all.
Because the AL]’s failure to adequately consider the impact of absenteeism due to
frequent medical appointments requites remand, the Court need not reach the further, related
issue of absenteeism due to migraines. All potential sources of missed work and off-task
behavior can be considered by the ALJ on remand in accordance with SSR 96-8p.
IT IS THEREFORE ORDERED that the Commissionet’s decision finding of no
disability is REVERSED, and that the matter is REMANDED to the Commissioner under
sentence four of 42 U.S.C. § 405(g). To this extent, it is further ORDERED that Defendant’s
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Dispositive Brief [Doc. #16] is DENIED, and Plaintiffs Dispositive Brief [Doc. #11] is
GRANTED to the extent set forth herein.
This, the 26 day of March, 2026.
h en Peake
nited States Magistrate Judge
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