‘Factually inaccurate’ disability denial over migraines remanded  

A northern Indiana woman may find some relief after the Northern District Court reversed and remanded the denial of her appeal for supplemental security income.

Rose Stoughton applied for supplemental security income in February 2015, alleging disability beginning Jan. 1, 2009. Stoughton was diagnosed with bipolar disorder and attention deficit disorder. A psychiatrist also determined her struggles focusing at work and coping stemmed from her mental status. She also experienced worsening migraines and was prescribed several medications for pain.

Stoughton’s application, however, was denied after an administrative law judge determined that although she did have severe impairments, she had not been disabled since the date of her filed application. The ALJ found Stoughton could perform routine, repetitive, and simple tasks because she was “able to understand, remember, and carry out instructions” related to those tasks.

But in her appeal, Stoughton argued that the ALJ failed to weigh the medical opinions of her physicians and impermissibly “played doctor” in the finding that her migraine headaches were nonsevere without relying on their medical opinions.

The Northern District Court agreed with Stoughton’s assertion in Stoughton v. Commissioner of Social Security, 3:18-cv-00484,  finding that the ALJ’s act of making no effort to weigh presented medical opinions required remand. It therefore reversed and remanded the case upon finding that the ALJ did not explain, as required, his decision to assign anything less than controlling weight to the medical opinions.

“The Commissioner does not contest whether Drs. (Shivam) Dubey and (Craig) Miller qualify as treating physicians, nor does he deny the fact that the ALJ made no attempt to weigh their opinions. Instead, the Commissioner’s only response is that these physicians’ treatment notes do not constitute medical opinions for Social Security purposes because the notes themselves do not opine on Ms. Stoughton’s functional limitations. As a result, the Commissioner argues, the ALJ did not err in neglecting to weigh these various reports because the regulations only required him to evaluate every medical opinion’ received,” District Judge Jon Deguilio wrote for the court.

“The Commissioner’s position does not persuade the Court for two main reasons. First, as set forth below, many of the treatment notes at issue indeed contain explicit opinions as to Ms. Stoughton’s functional limitations, and so the Commissioner’s argument to the contrary is factually inaccurate,” the panel continued. “Second, the regulations do not confine the definition of ‘medical opinions’ to conclusions on functional limitations, as the Commissioner would have it; nor do the regulations require a physician to opine on limitations — indeed, ‘they caution against doing so since ‘disability’ is a question ultimately left to the Commissioner.’”

The district court additionally found the ALJ’s determination that Stoughton’s migraines were nonsevere because she reported only having them “once in a while” and because they were treated with over-the-counter pain medication to be insufficient. It further noted that the ALJ completely overlooked the numerous, distinct occurrences between February 2014 and December 2015 in which Stoughton could not maintain attention, focus, and concentration in his determination of the work she could perform. It therefore remanded the case to the commissioner for further proceedings consistent with its opinion.

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