M.J. v. Frank Bisignano, Commissioner of Social Security

Summary

This memorandum opinion and order concerns judicial review of the Social Security Administration’s denial of M.J.’s applications for Title II and Title XVI disability benefits. The principal issue identified is whether the ALJ’s residual functional capacity assessment adequately accounted for the limiting effects of the claimant’s migraine headaches, including possible off-task limitations.

Holdings

1. The ALJ did not provide a legally sufficient explanation under Polaski and SSR 16-3p for discounting M.J.'s subjective complaints about her migraines.
2. The ALJ must reevaluate and adequately explain M.J.'s RFC in light of all relevant evidence concerning her migraines, including whether they require additional off-task or other functional limitations.
3. On remand, the ALJ must evaluate M.J.'s migraines at step three under Listing 11.02 in accordance with SSR 19-4p.
4. The ALJ must consider M.J.'s inability to afford or obtain Botox when evaluating the severity of her migraines and the effectiveness of treatment.
5. Sentence-four reversal and remand for further administrative proceedings, rather than an immediate award of benefits, is appropriate.

Questions Presented

1. Whether the ALJ adequately evaluated and explained the reasons for discounting M.J.'s subjective complaints concerning the frequency, severity, and functional effects of her migraines.
2. Whether the ALJ's residual functional capacity determination adequately accounted for the limiting effects of M.J.'s migraines, including potential off-task limitations.
3. Whether the ALJ was required at step three to evaluate M.J.'s primary headache disorder under Listing 11.02 pursuant to SSR 19-4p.
4. Whether the ALJ was required to consider M.J.'s inability to afford Botox when evaluating the effectiveness of treatment and the severity of her migraines.
5. Whether the case should be remanded for further administrative proceedings or an award of benefits.

Disposition

reversed_and_remanded