The opinion
IN THE UNITED STATES DISTRICT COURT
FOR THE WESTERN DISTRICT OF PENNSYLVANIA
AYLA MARIE BEY, )
)
Plaintiff, )
)
v. ) Civil Action No. 26-00121
) Judge Nora Barry Fischer
FRANK BISIGNANO, ) Docket No. 10
Commissioner of Social Security, )
)
Defendant. )
MEMORANDUM OPINION
I. INTRODUCTION
Ayla Marie Bey (“Plaintiff”) brings this action pursuant to 42 U.S.C. § 405(g), seeking
review of the final determination of the Commissioner of Social Security (“Defendant” or
“Commissioner”) denying her application for Supplemental Security Income (“SSI”) and
Disability Insurance Benefits (“DIB”) under Titles II and XVI of the Social Security Act, 42
U.S.C. §§ 1331-1383 (the “Act”). (Docket No. 11 at 1). Now pending before the Court is
Plaintiff’s Motion for Summary Judgment (Docket No. 10), which has been fully briefed.
(Docket Nos. 11-16).1
II. PROCEDURAL HISTORY
On July 7, 2023 Plaintiff filed an application for the aforesaid social security benefits,
alleging disability as of January 1, 1998 (age nine). The date she last met the insured status
requirements of the Act (her “date last insured” or “DLI”) was June 30, 2026. (Administrative
1 The has considered Plaintiff’s recently filed “Response to Defendant’s Surreply” and found it did not alter this
decision for reasons apparent herein. (Docket No. 16).
Transcript, Docket No. 5 (hereafter “Tr.”) at 223-39).2 Her application being denied by the
Social Security Administration (the “SSA”) on September 13, 2023 and March 28, 2024, at the
initial and reconsideration levels of review, respectively, it then proceeded to telephonic
Administrative Law Judge (“ALJ”) hearings before ALJ Sarah Ehasz on October 25, 2024 and,
following the discovery of a recording failure during that hearing, on March 5, 2025. Plaintiff and
an impartial vocational expert testified, and Plaintiff was represented by counsel during the
proceedings. (Tr. at 106-26, 43-67).
On May 12, 2025, ALJ Ehasz issued a detailed Decision finding that Plaintiff had not
established disability under sections 216(i) and 223(d) of the Act during the relevant period,
which the ALJ found to be from April 1, 2012 through the date of her decision,3 and denying her
application. In January 2026, the Appeals Council denied Plaintiff’s request for review,
rendering the ALJ’s Decision final pursuant to 20 C.F.R. § 404.981. (Tr. at 1-3, 19; Docket No.
11 at 2). Plaintiff filed suit in this Court on January 21, 2026, seeking the Court’s “review
pursuant to 205(g) and 1631(c)(1) of the Act, as amended, 42 U.S.C. §§ 405(g) and 1383(c)(3).”
(Docket No. 3 at 2). She specifically objects that the ALJ failed to properly (a) reopen her July
25, 2006 benefit application, which was dismissed for failure to appear at her requested hearing
in 2008; (b) evaluate her periods of abstinence from substance use; and (c) obtain medical expert
evaluation of the severity of her mental impairments. (Docket No. 11 at 1).
2 A certified copy of the transcript of the complete administrative proceedings was made of record at Docket No. 5 as
follows: 5-1 Court Transcript Index; 5-2 pp. 1-126; 5-3 pp. 127-47; 5-4 pp. 148-248; 5-5 pp. 249-71; 5-6 pp. 272-425;
5-7 pp. 426-661; 5-8 pp. 662-1223; 5-9 pp. 1224-1813; 5-10 pp. 1814-2529; 5-11 pp. 2530-3282; 5-12 pp. 3283-3835.
3 DIB may be provided to individuals who are “insured” by virtue of their contributions to the fund through the
applicable earnings tax. 20 C.F.R. §§ 404.110, 404.315. Plaintiff was not insured for benefits prior to April 1, 2012
(Tr. at 18). 42 U.S.C. § 423(a)(1)(A), (c)(1)(B); 20 C.F.R. §§ 404.101(a), 404.131(a). And as to SSI, the relevant
period began with July 7, 2023, the date Plaintiff filed her application for SSI (Tr. at 17). See 20 C.F.R. §§ 416.202,
416.501. See also Tr. at 19, 21; Docket No. 12 at 2, n.1.
The issues at hand include the above and, more generally, whether (a) the correct legal
standards were employed and (b) substantial evidence exists in the record to support the ALJ’s
Decision. On deferential review and as more fully set forth below, the Court finds that the
administrative record sufficiently supports the ALJ’s Decision, and that the proceedings and
determinations complied with the applicable standards. Plaintiff’s Motion for Summary
Judgment [10] is accordingly denied and judgment granted in favor of the SSA/Commissioner.
III. FACTUAL HISTORY
Plaintiff’s relevant history is highlighted in her Brief in Support (Docket No. 11, providing
citations to Transcript), and also set forth in the ALJ’s Decision (Tr. at 18-33, same), and the Court
incorporates it into its discussion in Section V. As an overview, Plaintiff was 23 years old when
first insured for benefits and 36 on the date of the decision. She has an early high school education,
little extended work experience, and a fairly lengthy medical history of struggle with substance use,
including incarcerations, motor vehicle accidents, and treatment programs with challenges as to
participation/compliance and including numerous medication protocols.
IV. STANDARD OF REVIEW
To be eligible for social security benefits under the Act, a claimant must demonstrate that
she cannot engage in “substantial gainful activity” because of a 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 at least twelve months. 42 U.S.C. § 423(d)(1)(A);
Brewster v. Heckler, 786 F.2d 581, 583 (3d Cir. 1986). When reviewing a claim, the ALJ must
utilize a five-step sequential analysis to evaluate whether a claimant has met the requirements for
disability. 20 C.F.R. §§ 404.1520, 416.920. The ALJ must determine: (1) whether the claimant is
currently engaged in substantial gainful activity; (2) if not, whether the claimant has a severe
impairment or a combination of impairments that is severe; (3) whether the medical evidence of
the claimant’s impairment or combination of impairments meets or equals the criteria listed in 20
C.F.R., Pt. 404, Subpt. P, App’x 1; (4) whether the claimant’s impairments prevent her from having
the Residual Functional Capacity (“RFC”) to perform her past relevant work; and (5) if the claimant
is incapable of performing her past relevant work, whether she can perform any other work which
exists in the national economy. 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4); see Barnhart v.
Thomas, 540 U.S. 20, 24–25 (2003). If the claimant is determined to be unable to resume previous
employment, the burden shifts to the SSA/Commissioner at step 5 to prove that, given claimant’s
mental or physical limitations (i.e., her RFC), age, education, and work experience, she is able to
perform substantial gainful activity in jobs available in the national economy. See e.g., Edwards
v. Berryhill, No. CV 16-475, 2017 WL 1344436, at *1 (W.D. Pa. Apr. 12, 2017); Doak v. Heckler,
790 F.2d 26, 28 (3d Cir. 1986). See also Tr. 20-21.
The Court’s review of the agency’s final decision is plenary for questions of law.
Schaudeck v. Comm’r of Soc. Sec., 181 F.3d 429, 431 (3d Cir. 1999). It reviews the ALJ’s findings
of fact for “substantial evidence” and reviews the administrative record as a whole. Biestek v.
Berryhill, 139 S. Ct. 1148, 1152 (2019) (quoting 42 U.S.C. § 405(g));4 Burns v. Barnhart, 312 F.3d
113, 118 (3d Cir. 2002); Kent v. Schweiker, 710 F.2d 110 (3d Cir. 1983). This evidentiary threshold
is not high, and “substantial evidence” means only “such relevant evidence as a reasonable mind
might accept as adequate to support a conclusion.” Biestek, 139 S. Ct. at 1154; Ventura v. Shalala,
55 F.3d 900, 901 (3d Cir. 1995) (quoting Richardson v. Perales, 402 U.S. 389, 401 (1971)). If the
4 Section 405(g) provides in pertinent part:
Any individual, after any final decision of the [Commissioner] made after a hearing to which he was
a party, irrespective of the amount in controversy, may obtain a review of such decision by a civil
action ... brought in the district court of the United States for the judicial district in which the plaintiff
resides, or has his principal place of business.
ALJ’s decision is supported by such evidence, it is conclusive.5 The Court may not “set aside” the
decision “even if this Court ‘would have decided the factual inquiry differently.’” Hansford v.
Astrue, 805 F. Supp. 2d 140, 143 (W.D. Pa. 2011) (quoting Hartranft v. Apfel, 181 F.3d 358, 360
(3d Cir. 1999)).6
IV. ANALYSIS
The lengthy Decision rendered by ALJ Ehasz found that Plaintiff (1) during the relevant
period of 2012 to 2025, engaged in substantial gainful activity only in the two-year interval of
January 1, 2015 to December 31, 2016; (2) had the severe impairments of (a) anxiety, bipolar,
trauma/stressor, depressive, and multiple substance use disorders; and (b) cluster B personality
traits;7 (3) did not have an impairment or combination of impairments meeting or equaling the
5 As the Supreme Court has explained, however, the ALJ must provide a satisfactorily clear articulation of the basis
for her conclusions:
An agency action qualifies as “arbitrary” or “capricious” if it is not “reasonable and reasonably
explained.” FCC v. Prometheus Radio Project, 592 U. S. 414, 423, 141 S. Ct. 1150, 209 L. Ed. 2d
287 (2021). In reviewing an agency’s action under that standard, a court may not “‘substitute its
judgment for that of the Agency.’” FCC v. Fox Television Stations, Inc., 556 U. S. 502, 513, 129 S.
Ct. 1800, 173 L. Ed. 2d 738 (2009). But it must ensure, among other things, that the agency has
offered “a satisfactory explanation for its action[,] including a rational connection between the facts
found and the choice made.” Motor Vehicle Mfrs. Assn. of United States, Inc. v. State Farm Mut.
Automobile Ins. Co., 463 U.S. 29, 43, 103 S. Ct. 2856, 77 L. Ed. 2d 443 (1983).
Ohio v. EPA, Nos. 23A349, 23A350, 23A351, 23A384, 2024 U.S. LEXIS 2846, at *18 (June 27, 2024); see also Cotter
v. Harris, 642 F.2d 700, 704-05 (3d Cir. 1981).
6 As the Supreme Court reiterated in Ohio v. EPA, supra, when considering a case, a district court can neither conduct
a de novo review of the decision nor re-weigh the evidence of record. It must judge, under the applicable standard, the
propriety of the decision in reference to the grounds invoked by the Commissioner when the decision was rendered.
Palmer v. Apfel, 995 F. Supp. 549, 552 (E.D. Pa. 1998); S.E.C. v. Chenery Corp., 332 U.S. 194, 196–97 (1947).
7 Tr. at 21 (citing 20 CFR 404.1520(c) and 416.920(c)). The ALJ further found - on review and consideration of all
the medical evidence in Plaintiff’s file – that Plaintiff’s multiple other alleged conditions (asthma, urinary tract
infections, TMJ, acid reflux, otitis media and otitis externa) which met the regulatory requirements for a medically
determinable impairment (“MDI”) established by an acceptable medical source, were not shown to have more than
minimally limited her work-related functioning for the period at issue. Tr. at 22. See also id. (discussing consideration
of both established severe impairments and all MDI in assessing Plaintiff’s RFC and, on the basis of her non-severe
asthma, “limit[ing] her to frequent concentrated exposure to weather, humidity and wetness, dust, odors, fumes, and
pulmonary irritants, and occasional exposure to extreme cold and heat”).
severity of one of the criteria listed; (4) had no past relevant work; and (5) had the residual
functional capacity (“RFC”) to perform work with some restrictions, which work is sufficiently
available in the national economy.8 Plaintiff’s claim was therefore denied at step (5). See generally
Tr. at 18-32.
The Court is not unsympathetic to Plaintiff’s medical history, including her long history of
struggle with substance use, as presented in her pleadings. (Docket Nos. 3 and 11). It must,
however, reject Plaintiff’s contentions of error warranting remand and affirm the ALJ’s Decision.
It does so on the basis of its review and above explication of the facially thorough Decision
challenged. In further response to Plaintiff’s averments of error/entitlement to remand:
See also id. at 22-24 (providing comprehensive discussion of ALJ’s consideration of Plaintiff’s broad areas of mental
functioning - under the regulatory “paragraph B” criteria, with citations to the normal, intact, mild and moderate
findings of record). More specifically, the ALJ found Plaintiff to have mild limitations in understanding, remembering
or applying information. And she found Plaintiff to have moderate limitations in (a) interacting with others; (b)
concentrating, persisting or maintaining pace; and (c) adapting or managing oneself adapting or managing oneself. Id.
(discuss the medical findings of record and hearing testimony). Cf. id at 24 (finding that the paragraph C criteria were
not met).
8 See Tr. at 24-29 (ALJ’s extensive explanation of the process and bases of her findings of RFC). The ALJ found that
Plaintiff had the RFC to perform a full range of work at all exertional levels with the following non-exertional
limitations:
• No ladders, ropes or scaffolds.
• No work at unprotected heights, or around dangerous machinery, and no operation of a
motor vehicle.
• Limited to frequent concentrated exposure to weather, humidity and wetness, dust, odors,
fumes, and pulmonary irritants.
• Only occasional exposure to extreme cold and heat.
• Limited to simple, routine and repetitive tasks but not at a production rate pace and
simple work-related decisions.
• Limited to frequent interaction with supervisors, only occasional interaction with
coworkers, and no interaction with the public.
In so finding, ALJ Ehasz noted her obligation to “consider[] all symptoms and the extent to which these symptoms can
reasonably be accepted as consistent with the objective medical evidence and other evidence, based on the requirements
of 20 CFR 404.1529 and 416.929 and SSR 16-3p [as well as] the medical opinion(s) and prior administrative medical
finding(s) in accordance with the requirements of 20 CFR 404.1520c and 416.920c.” (Tr. at 24).
(1) Plaintiff objects that the ALJ failed to grant her request to reopen her July 25, 2006
application for SSI, which was denied on initial and reconsideration reviews and then dismissed –
subsequent to Plaintiff’s failure to appear for her May 30, 2008 hearing - more than fourteen (14)
years prior to Plaintiff’s 2023 request. In particular, Plaintiff objects that insufficient efforts were
made to locate Plaintiff and notify her of the hearing at the time, and that she was injured by
“clerical error”. The Decision recited the governing regulations in reaching its denial of Plaintiff’s
request to reopen:
20 CFR 416.1488 allows for reopening of a Title XVI application within 12 months
of the date of the notice of the initial determination for any reason, within two years
of the date of the notice of the initial determination if we find good cause, and at
any time if it was obtained by fraud or similar fault. This request was made more
than 14 years [later, and] there is no evidence of fraud or similar fault. Attempts
were made by the hearing office to locate the claimant at the time of the scheduled
hearing including, a Postal Search showing that the claimant moved with no
forwarding address and a phone call to the number on file, which had been
disconnected (Exhibit 1A).
Tr. at 18-19. See also Docket 15 at 2 (noting that “clerical error” falls under “good cause”).9
9 Cf. also:
Ҥ 416.1488. Conditions for reopening.
A determination, revised determination, decision, or revised decision may be reopened—
(c) At any time if it was obtained by fraud or similar fault. In determining whether a determination
or decision was obtained by fraud or similar fault, we will take into account any physical, mental,
educational, or linguistic limitations (including any lack of facility with the English language) which
you may have had at the time.
§ 416.1489. Good causes for reopening
(a) We will find that there is good cause to reopen a determination or decision if—
(1) New and material evidence is furnished;
(2) A clerical error was made; or
(3) The evidence that was considered in making the determination or decision clearly shows on
its face that an error was made.
See, 20 CFR § 416.1488(c); 416.1489(1)(2)(3), respectfully. . . .”
(cited in Docket No. 13 at 2) (emphasis omitted)
As Defendant correctly notes, a refusal to reopen a prior claim is not a “final
decision” subject to judicial review under 42 U.S.C. § 405(g). (Docket No. 12 at 9) (citing
Califano v. Sanders, 430 U.S. 99, 107– 09 (1977)). See also Smith v. Berryhill, 587 U.S.
471, 471–72 (2019) (distinguishing itself, as a case involving Appeal’s Counsel’s dismissal
of a claim following a hearing on the merits, from Sanders, “where the Court found that the
SSA's denial of a claimant's petition to reopen a prior denial of his claim for benefits - a
second look that the agency had made available to claimants as a matter of grace - was not
a final decision under § 405(g)”).
Plaintiff’s attempts to circumvent this jurisdictional bar by alleging a de facto
reopening or a due process violation are unavailing.10 The Decision expressly declined to
reopen the prior application, and the ALJ’s appropriate inclusion of some of Plaintiff’s
fuller/longitudinal context in her review and discussion of the medical record did not
constitute a reopening. Plaintiff cites no case to the contrary. In addition, Plaintiff’s
averments of a constitutional violation based on asserted address/notice matters regarding
her 2006 proceeding are simply not colorable within the meaning of Sanders, Plaintiff’s
argument improperly relies on alleged evidence/omissions in a record not before the court,
and there is no indication that the agency failed to follow its own procedures. The Court
largely concurs in Defendant’s adequate responses to these averments. See Docket No. 15
at 2-3; Docket No. 12 at 9-10.11
10 The narrow exception to this jurisdictional bar applies only where a claimant raises a colorable constitutional claim.
(Docket No. 12 at 9) (citing Sanders, 430 U.S. at 109; Penner v. Schweiker, 701 F.2d 256, 260 (3d Cir. 1983)).
11 Cf. id. at 11 (also addressing Plaintiff’s erroneous reliance on reopening regulations under Title II, rather than those
under Title XVI, as to alleged clerical error).
Cf. Docket No. 15 at 3-4 (noting that under various regulatory sections, Plaintiff may, on a good cause showing, yet
appeal the dismissal underlying the ALJ’s decision to deny her request to reopen a determination, where it is, as here,
not subject to the administrative review process) (citing applicable provisions).
(2) Plaintiff objects that the ALJ failed to evaluate her periods of abstinence from substance
use, particularly during incarceration. (Docket No. 11 at 4-5). The Court notes that the record
reflects challenges in ascertaining such periods with certainty. For example, as noted in the
Decision, Plaintiff “testified that she had been clean for two weeks at the time of the hearing, but
prior to that had no significant period during which she was clean other than when she was [in
treatment] in August or September of 2024” and, more generally, “has had minimal mental health
treatment over the years [approximately 2013 through 2024] other than that received while in
treatment for her substance use or while incarcerated.” (Tr. at 25). Cf. Tr. at 26 (noting that in
August 2017, Plaintiff was incarcerated and “stated that her longest clean period had been from
September of 2015 to January of 2017, but that she was not in any formal treatment then, just
working a lot”).
That said, the ALJ’s Decision provides a chronologic explication of the evidence of record
regarding Plaintiff substance use, periods of incarceration, concurrent or other intervals of inpatient
or outpatient therapy/treatment, her treatment/medication participation/compliance, and in those
contexts incorporates evidence regarding her self-reporting and psychiatric/other mental health
status exams. (Tr. at 25-29).12 The Court thus finds it more than sufficient under the applicable
standard of review.
(3) Finally, Plaintiffs objects that the ALJ failed to obtain medical expert evaluation of the
severity of her mental impairments, instead denying that request on grounds there was “sufficient
12 Cf. Docket No. 12 at 6 (“Because the ALJ did not find Plaintiff disabled at any point in the sequential evaluation,
there was no need to conduct a drug addiction and alcoholism (“DAA”) materiality analysis or to parse out periods of
abstinence. Agency policy makes clear that such analysis is required only where the claimant is first found disabled.
See Social Security Ruling (SSR) 13-2p, 2013 WL 621536. . . . In any event, the ALJ’s decision reflects a
comprehensive evaluation of Plaintiff’s functioning across the entire period at issue . . . .”).
information available in the file to make a decision without the need for a medical expert.” (Docket
No. 11 at 4-6; Tr. at 18-19).
As reflected above, the ALJ reviewed and incorporated her assessment of the medical
evidence of record regarding Plaintiff’s mental health record. This properly included “prior
administrative medical finding(s) or medical opinion(s),” such as those of Austin Brown, Psy.D;
and State Agency psychological consultants Melissa Lynn Franks, Psy.D, and John David Chiampi,
Ph.D. (Tr. at 30-31). The ALJ found Drs. Brown’s and Franks’ opinions somewhat persuasive but
reflected further “paragraph B” limitations in her RFC in consideration of Plaintiff’s “ongoing
mental health symptoms and substance use”. (Tr. at 30).
And the ALJ duly evaluated the claimant’s subjective perceptions or statements about, e.g.,
the intensity, persistence or functionally limiting effects of pain or other symptoms, in the context
of (a) their substantiation by/consistency with medical and other evidence of record and (b) her
determination of the extent to which they might limit the claimant’s work-related activities. (Tr.
at 24-29).13 This assessment is delegated to the ALJ, subject to the Court’s deferential review.
Moreover, as Defendant notes, an ALJ has broad discretion to determine whether medical
expert testimony is necessary. (Docket No. 12 at 7-8) (citing Thompson v. Halter, 45 F. App’x 146,
149 (3d Cir. 2002); Kushner v. Comm’r Soc. Sec., 765 F. App’x 825, 829 n.3 (3d Cir. 2019)). See
13 Cf. Tr. at 24-25 (correctly noting the two-step process that begins with the ALJ’s determination of “an underlying
medically determinable physical or mental impairment” - i.e., one “that can be shown by medically acceptable clinical
or laboratory diagnostic techniques – that could reasonably be expected to produce the claimant’s pain or other
symptoms”); id. at 25, 29 (ALJ’s consideration of Plaintiff’s subjective statements regarding the intensity, persistence
or functionally limiting effects of her symptoms, and finding that some were “not entirely consistent with” the medical
and other record evidence for reasons explained in the ALJ’s Decision, including inconsistencies in
representations/testimony and factual record).
Cf. also id. at 29 (noting, with citation to record, inconsistencies in Plaintiff’s testimony regarding, e.g., having a
driver’s license, taking public transportation, and abilities to perform personal care tasks, household responsibilities
such a laundry, meals and simply financial matters, and care for her teenaged daughter).
also 20 C.F.R. §§ 404.1519a(b), 416.919a(b). ALJ Ehasz was under no obligation to order medical
expert testimony where, as discussed above, the record was, under the applicable standard, more
than sufficient to her decision.14
V. CONCLUSION
In sum, the Court has applied the applicable standard and finds that the ALJ’s Decision (a)
comprehensively included, considered and referenced the evidence relating to Plaintiff’s subjective
reporting, symptoms, medical conditions, and limitations during the relevant period, (b) more than
sufficiently explained the ALJ’s reasonings and findings to permit the Court’s meaningful review,
(c) included related reasonably demonstrated limitations during the period at issue in its RFC, and
(d) based its denial of benefits on substantial evidence found and reasonable determinations made.
See Sections III and IV, supra. Plaintiff’s Motion for Summary Judgment [10] is therefore denied
and the decision of the SSA/Commissioner is affirmed. An appropriate Order follows.
s/ Nora Barry Fischer
Nora Barry Fischer
Senior U.S. District Judge
Dated: July 6, 2026
cc/ecf: All counsel of record.
14 The Court rejects Plaintiff’s assertions that the ALJ mischaracterized the evidence, failed to provide Plaintiff
appropriate due process, or omitted required determinations (such as an onset date), from her Decision, for reasons
reflected in this Memorandum Opinion and in Defendant’s Brief in Opposition, as to which it largely concurs. See
Docket No. 12 at 8-10