Caseflicks

Court of Appeals for the Fourth Circuit • 2015

Bonnilyn Mascio v. Carolyn Colvin

780 F.3d 632 | 2015 U.S. App. LEXIS 4328

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Takeaway

In short, this case requires an ALJ to build a reviewable bridge from the evidence to the RFC: assess relevant functions, explain how concentration, persistence, or pace limitations affect work, and evaluate symptoms before using them to formulate the RFC.

Background

Bonnilyn Mascio sought supplemental security income based on degenerative disc disease, carpal tunnel syndrome, adjustment disorder, and a history of substance abuse. An earlier ALJ denial had already been reversed and remanded. On remand, a second ALJ found that Mascio was not disabled from March 15, 2005, through November 30, 2009. While that appeal was pending, the agency approved benefits beginning December 1, 2009.

Applying the five-step disability framework, the second ALJ found Mascio had severe impairments but did not meet a listed impairment. The ALJ assessed an RFC for light, unskilled work with a sit/stand option and several postural, manipulative, and environmental restrictions. The ALJ found that she could not perform her past work but could perform other jobs identified by a vocational expert. The district court granted the Commissioner's motion for judgment on the pleadings and upheld the denial of benefits.

Mascio appealed, alleging that the ALJ failed to perform a proper function-by-function RFC analysis, omitted a concentration, persistence, or pace limitation from the vocational hypothetical, assessed RFC before properly evaluating credibility, and failed to give sufficient weight to her subjective pain allegations.

Issues

Issue #1

Whether the ALJ's RFC assessment required remand because it did not include an adequate function-by-function analysis.

Holding

Yes. Although an explicit function-by-function discussion is not required in every case, remand was required here because the ALJ's incomplete analysis and unexplained treatment of conflicting evidence prevented meaningful judicial review.

Reasoning

Social Security Ruling 96-8p requires an ALJ to identify a claimant's functional limitations and assess work-related abilities on a function-by-function basis before expressing the RFC in broad exertional terms such as light work. The RFC decision must also contain a narrative explaining how specific medical and nonmedical evidence supports each conclusion.

The Fourth Circuit declined to adopt a per se rule requiring remand whenever an ALJ fails to spell out every function separately. Remand would be futile where omitted functions are irrelevant or uncontested. But remand is appropriate when the ALJ fails to assess relevant functions despite conflicting evidence, or when deficiencies in the explanation frustrate meaningful review.

Here, the ALJ stated what Mascio could do but did not explain whether she could perform those functions throughout a full workday. The omission was especially serious because the record included conflicting state-agency RFC assessments: one supported medium work and lifting up to fifty pounds, while another limited Mascio to twenty pounds. The ALJ's light-work finding appeared more consistent with the latter assessment, yet the ALJ did not discuss it and left an incomplete sentence where he appeared prepared to state the weight assigned to the former assessment. The court therefore could not tell how the ALJ reached the functional conclusions.

Issue #2

Whether limiting Mascio to unskilled work adequately accounted for the ALJ's finding that she had moderate difficulties in concentration, persistence, or pace.

Holding

No. A restriction to unskilled work does not, by itself, account for a moderate limitation in concentration, persistence, or pace, and the ALJ gave no explanation for omitting that limitation from the RFC and vocational hypothetical.

Reasoning

At step three, the ALJ found that Mascio had moderate difficulties in concentration, persistence, or pace, in part because pain medication affected her thought processes. Yet the RFC and the hypothetical posed to the vocational expert included only physical restrictions and, through the expert's response, an unskilled-work limitation.

The ability to perform simple tasks is different from the ability to remain on task. Unskilled work may address the complexity of tasks, but it does not necessarily address a claimant's capacity to sustain concentration, persistence, and pace for a workday. Thus, an unskilled-work restriction cannot automatically substitute for a limitation concerning staying on task.

An ALJ may exclude a step-three concentration, persistence, or pace limitation from the RFC if the ALJ explains why that limitation does not affect the claimant's ability to work. But the ALJ did not do so here. His treatment of Mascio's fatigue and medication effects was also unclear: he discounted her report of daytime fatigue, yet elsewhere found that her medication affected her thought processes. That inconsistency required explanation on remand.

Issue #3

Whether the ALJ improperly evaluated Mascio's credibility by comparing her symptom allegations to an RFC already determined.

Holding

Yes. The ALJ used circular boilerplate and did not otherwise adequately explain which of Mascio's symptom allegations he credited or rejected and why.

Reasoning

The ALJ stated that Mascio's symptoms were not credible to the extent they were inconsistent with the previously stated RFC. That formulation reverses the required order of analysis: the ALJ must evaluate the claimant's alleged limitations against the record to determine how symptoms affect the ability to work, and then incorporate the resulting findings into the RFC.

Pain symptoms and RFC are not separate conclusions to be compared against one another. Under the governing regulations and Social Security Ruling 96-8p, the effects of symptoms, including pain, are evidence that must be considered in forming the RFC itself. The boilerplate therefore suggested an improper, circular credibility analysis.

The error was not harmless because the ALJ did not supply an adequate credibility analysis elsewhere. Failure to attend mental-health appointments did not bear on Mascio's pain allegations, while her dishonesty about marijuana use and conviction for selling prescription medication showed only that her reports were less credible, not which particular functional claims were accepted or rejected. The ALJ appeared to credit her claim that she could stand only thirty minutes by adopting a sit/stand option, but did not explain why he rejected her asserted limits on walking and lifting while finding her capable of light work.

Issue #4

Whether the Fourth Circuit recognizes a rule requiring ALJs to give great weight to uncontradicted or substantially supported subjective pain evidence.

Holding

No. The court declined to adopt a categorical "great weight rule" for subjective complaints of pain.

Reasoning

Mascio relied on language in two unpublished Fourth Circuit decisions stating that subjective evidence may be entitled to great weight. The court explained that those cases did not create a mandatory rule. They recognized only that an ALJ may credit uncontradicted or well-supported subjective pain evidence when the ALJ finds the claimant credible.

A mandatory great-weight rule would conflict with the regulations, which require an ALJ to consider all available evidence rather than pain allegations alone. It would also be inconsistent with the deferential substantial-evidence standard of review, because substantial evidence can support both evidence of pain and an ALJ's conclusion that the pain is not as work-limiting as the claimant alleges.