Reported / Citable
Background
Ira Wesley F. filed a claim for disability insurance benefits on February 25, 2021, alleging disability beginning January 2, 2015. The Social Security Administration initially denied the claim in May 2021 and again on reconsideration in November 2021. After requesting a hearing, Administrative Law Judge Michelle Whetsel conducted a telephonic hearing on December 6, 2023, where Plaintiff was represented by counsel and a vocational expert testified.
The ALJ issued a decision on January 18, 2024, finding Plaintiff not disabled at Step Five of the five-step disability evaluation. The ALJ determined Plaintiff had severe impairments including stroke/Erb’s palsy, diabetes, hypertension, and congestive heart failure, but possessed a residual functional capacity to perform light work with specified limitations. The ALJ concluded jobs existed in the national economy that Plaintiff could perform, such as router, routing clerk, and housekeeper. The Appeals Council denied Plaintiff’s request for review on October 21, 2024, making the ALJ’s decision the Commissioner’s final decision.
The Court’s Holding
The magistrate judge recommended granting in part and denying in part both parties’ cross-motions for summary judgment. While the court rejected Plaintiff’s argument that the ALJ impermissibly relied on lay opinion, it found legal error in the ALJ’s evaluation of medical opinions under 20 C.F.R. § 404.1520c(b).
Under the 2017 regulations, ALJs must articulate how persuasive they find each medical opinion using specific factors, with “supportability” and “consistency” being the most important. The court found the ALJ failed to adequately discuss supportability and consistency for three physicians’ opinions. Regarding Dr. Daniel’s opinion, the ALJ stated it provided “no function-by-function assessment” but failed to meaningfully address supportability—yet the regulations do not require function-by-function assessments. For Dr. Sarkar’s opinion, the ALJ discussed consistency but provided only a singular, inadequate reference to supportability. For Dr. Bloodworth’s opinion, the ALJ addressed neither supportability nor consistency, merely noting the opinion opined on disability status.
The court determined this legal error was not harmless. Because the ALJ failed to meaningfully engage with three of six medical opinions, the court could not undertake meaningful review of whether substantial evidence supported the ALJ’s decision. Accordingly, the court recommended remanding the case to the Social Security Administration for further proceedings consistent with the opinion.
Key Takeaways
- ALJs must articulate their reasoning on both “supportability” and “consistency” when evaluating medical opinions under 20 C.F.R. § 404.1520c(b), not just consistency alone.
- An absence of a “function-by-function assessment” in a medical opinion does not relieve an ALJ of the duty to evaluate the opinion’s supportability and consistency under the regulatory standard.
- Failure to meaningfully discuss the consistency and supportability factors for medical opinions constitutes reversible error that prevents meaningful judicial review, even if other opinions were properly analyzed.
Why It Matters
This decision reinforces the Fifth Circuit’s stringent requirements for ALJ compliance with 20 C.F.R. § 404.1520c(b). Since the 2017 regulation change, ALJs can no longer defer to or give controlling weight to any medical opinion, but must apply specific regulatory factors and explain their reasoning. The court rejected the ALJ’s attempt to use lack of “function-by-function assessment” as a shorthand reason to avoid meaningful evaluation of medical evidence. This ruling emphasizes that ALJs must engage substantively with the medical evidence supporting physicians’ opinions, not merely reference whether opinions align with other evidence.
The remand signals that courts will scrutinize whether ALJs have provided sufficient reasoning to permit appellate review. Even when an ALJ considers medical opinions and develops an RFC, failure to articulate how supportability and consistency factors were weighed creates a gap in the administrative record that undermines the substantial evidence standard. For practitioners, this case underscores the importance of preserving detailed medical opinions that explain the factual and clinical bases for functional limitations in Social Security cases.