H-L. v. Bisignano
- Elsa Bullard
- 0:25-cv-01045
- U.S. District Court · District of Minnesota
- 23
In Lori H-L. v. Frank Bisignano, Commissioner of Social Security, Magistrate Judge Elsa M. Bullard remanded the case back to the Social Security Administration because the Administrative Law Judge failed to properly analyze the claimant's somatic symptom disorder — a condition causing a person to genuinely perceive physical symptoms as more severe than medical tests can confirm — and also failed to adequately assess whether her chronic migraines and headaches were disabling under the applicable federal standard.
Individuals who have applied for Social Security disability insurance benefits and whose claims were denied, particularly claimants who suffer from somatic symptom disorder or other conditions where perceived symptoms exceed objective clinical findings, and claimants with chronic migraines or headache disorders whose cases were evaluated under Listing 11.02.
What happened
In Lori H-L. v. Frank Bisignano, Commissioner of Social Security (Case No. 25-cv-1045-EMB), Lori H-L. applied for Social Security disability insurance benefits in September 2021, claiming disability since July 31, 2019, due to a wide range of physical and mental conditions including a right shoulder rotator cuff tear, complex regional pain syndrome, chronic migraines, fibromyalgia, post-traumatic stress disorder, and somatic symptom disorder, among others. The Social Security Administration denied her application twice, and after a hearing before an Administrative Law Judge (ALJ) in October 2023, the ALJ concluded she was not disabled and could perform jobs such as merchandise marker, inspector, or production assembler. The Social Security Appeals Council declined to review that decision, making it final, and Lori H-L. then brought this lawsuit seeking court review.
The court focused on two main problems with the ALJ's decision. First, despite finding that Lori H-L. suffered from somatic symptom disorder — a condition where a person genuinely experiences physical symptoms at a greater level of severity than clinical evidence can explain — the ALJ barely mentioned that condition and never explained how it might affect his assessment of her reported symptoms. The ALJ dismissed her subjective complaints partly by pointing to her daily activities, such as gardening and deer hunting, but the court found those references were misleading: the gardening evidence largely reflected future plans or heavily assisted activities done as part of her medical treatment, not evidence of real work capacity. The ALJ also failed to address significant testimony, such as Lori H-L.'s statement that she showers only once every two weeks due to pain, had lost roughly 75 pounds because she often could not prepare food, and frequently spent hours lying in a dark room. Second, the ALJ's brief analysis of whether her migraines qualified as disabling under the governing federal listing (a standard based on epilepsy criteria used as the closest analogy for severe headaches) was insufficient and appeared to rely on the same flawed credibility analysis.
Magistrate Judge Elsa M. Bullard granted Lori H-L.'s request for relief, denied the Commissioner's opposition, and remanded — that is, sent the case back — to the Social Security Administration for further review. On remand, the ALJ must reassess Lori H-L.'s subjective symptom reports in light of her somatic symptom disorder, provide a clearer and more detailed explanation of which statements are credited and why, reconsider whether her headaches meet or equal the relevant disability listing, and also consider whether she was entitled to benefits for any closed twelve-month period. The court declined to rule on the closed-period argument directly, leaving it for the ALJ to address on remand.
The detailed version
- H-L. v. Bisignano · No. 0:25-cv-01045
- Elsa M. Bullard
- Mar. 31, 2026
Background
Plaintiff Lori H-L. applied for Social Security disability insurance benefits (DIB) on September 24, 2021, alleging disability since July 31, 2019 — the date of a workplace injury. The Social Security Administration (SSA) denied her application on July 1, 2022, and again on reconsideration on March 1, 2023. An Administrative Law Judge (ALJ) held a remote hearing on October 25, 2023, at which Lori H-L., then 53 years old, testified.
The ALJ found the following severe impairments: right shoulder injury with rotator cuff tear; complex regional pain syndrome of the right upper extremity; resting tremor; lumbar degenerative disc disease; post-concussive syndrome; chronic migraines; chronic pain syndrome; fibromyalgia; generalized anxiety disorder; mood disorder; adjustment disorder; post-traumatic stress disorder; and somatic symptom disorder. Despite finding these severe impairments, the ALJ ultimately concluded Lori H-L. was not disabled under the Social Security Act and could perform light work, including jobs as merchandise marker, inspector and hand packager, and production assembler.
The SSA Appeals Council denied review, making the ALJ's decision final. Lori H-L. timely filed this action seeking judicial review under 42 U.S.C. § 405(g).
Standard of Review
The court's review is limited to two questions: (1) whether the ALJ committed a legal error, and (2) whether the decision was supported by "substantial evidence" — meaning more than a mere scintilla, or such relevant evidence as a reasonable mind might accept as adequate to support a conclusion. The court must consider the entire record, including both supporting and contrary evidence, but may not reweigh that evidence. If the record supports two reasonable conclusions and one matches the ALJ's, the court must affirm.
The Five-Step Sequential Evaluation
The ALJ applied the standard five-step process for determining disability under 20 C.F.R. § 404.1520:
- Step 1: The ALJ found Lori H-L. had not engaged in substantial gainful activity since July 31, 2019. (Claimant prevailed.) - Step 2: The ALJ found multiple severe impairments, as listed above. (Claimant prevailed.) - Step 3: The ALJ found her impairments did not meet or medically equal any listed impairment in the regulations, including Listing 11.02, the closest analogue for primary headache disorders. (Claimant did not prevail.) - RFC Assessment (between Steps 3 and 4): The ALJ determined Lori H-L.'s residual functional capacity (RFC) — the most she can still do despite her limitations — to be light work with numerous restrictions, including only occasional pushing/pulling and overhead reaching with the right arm, no climbing ladders or scaffolding, no crawling, no exposure to heights or heavy machinery, and mental limitations to simple instructions and occasional changes in a routine work setting. - Step 4: The ALJ found she could not return to any past relevant work. (Claimant prevailed.) - Step 5: The burden shifts to the Commissioner. The ALJ found she could perform other jobs existing in significant numbers nationally, leading to a finding of not disabled.
Issue 1: RFC and Somatic Symptom Disorder
Legal Framework
Social Security Ruling (SSR) 16-3p requires the ALJ, once he finds that a claimant has a medically determinable impairment that could reasonably produce the alleged symptoms (as the ALJ did here), to evaluate the intensity, persistence, and limiting effects of those symptoms using seven factors, including daily activities, frequency and intensity of pain, medication effects, and other functional limitations. The ALJ need not exhaustively address every factor, but must build a logical bridge between the evidence and his conclusions.
Where a claimant has a somatoform (somatic symptom) disorder — a condition in which the person genuinely experiences physical symptoms at a greater severity than clinical evidence supports — the ALJ may not reject subjective complaints without an express finding regarding the consistency of her testimony with the record as a whole. If the ALJ accepts the somatoform diagnosis but finds the claimant's statements partially inconsistent, the ALJ must set forth that consistency determination with sufficient detail to permit meaningful judicial review. See Nowling v. Colvin, 813 F.3d 1110, 1114 (8th Cir. 2016). Note: SSR 16-3p (effective 2017) replaced the term "credibility" with a consistency analysis; the Nowling requirement of sufficient detail survives this change, per Lawrence v. Saul, 970 F.3d 989 (8th Cir. 2020).
The ALJ's Errors
Failure to address somatic symptom disorder. Although the ALJ found somatic symptom disorder to be a severe impairment, his written decision made only passing references to it. He never explained how that disorder might cause Lori H-L. to perceive her physical symptoms — pain, headaches, sensitivity — as more severe than clinical tests reflect. This is a critical omission because the ALJ separately acknowledged that her treatment and symptom reports were "out of proportion" to objective findings, yet never connected that observation to the known nature of somatic symptom disorder.
Mischaracterization of daily activities. The ALJ's finding that Lori H-L.'s activities were inconsistent with claims of debilitating pain relied heavily on activities that the record either described as future plans, heavily modified tasks, or medically prescribed therapeutic exercises:
- Gardening: Much of the record discussed future plans to garden, not actual current activity. Concrete references described gardening as slow, requiring neighbor or family assistance, or done in raised beds to reduce difficulty — all as part of her physical therapy to improve right wrist and elbow function. - Farming/side income: The ALJ cited plans to improve her farm and explore side income, but there was no evidence she actually did farm work or earned side income. - Deer hunting: A notation described Plaintiff making "efforts to engage in the valued hobby of hunting via a modified approach" — which the court did not treat as evidence of work capacity. - Holiday activity: A notation that she was "very busy over the holidays" contained no elaboration; meanwhile, Lori H-L. testified she had missed holidays, funerals, and weddings. - Driving: While her driving limit increased to 40 miles (from 15), the ALJ acknowledged she testified she cannot drive at all on certain days. - Home exercise program: A note showing she was independent with her shoulder exercises also documented ongoing limitations from complex regional pain syndrome.
Failure to address significant testimony. The ALJ discounted Lori H-L.'s subjective complaints without addressing key testimony: that she showers only once every two weeks due to pain described as "a million knives" cutting through her skin; that she had lost approximately 75 pounds (from 195 lbs. in February 2020 to 120 lbs. at the October 2023 hearing) because she was often unable to prepare food; and that she spends several hours at a time lying in a dark room and could not sustain a 40-hour work week.
Failure to link inconsistencies to specific statements. Even where the ALJ identified inconsistencies, he did not connect them to specific subjective statements by Lori H-L., making meaningful judicial review impossible.
Disposition on RFC
The court remanded for the ALJ to reassess Lori H-L.'s subjective symptoms under SSR 16-3p, to explain with sufficient detail which statements are credited and which are not and why, and to consider how somatic symptom disorder affects the perceived intensity of her symptoms.
Issue 2: Listing 11.02 (Headaches/Migraines)
There is no specific listing for migraines or headaches in the Social Security regulations. Under SSR 19-4p, Listing 11.02 (epilepsy) is the most closely analogous listing for a primary headache disorder. The relevant question is not whether a claimant's headaches satisfy the exact seizure criteria of Listing 11.02, but whether the headaches are equal in severity and duration to those criteria. The court noted that the ALJ may have erred by asking the wrong question — whether the claimant met Listing 11.02 exactly (including actual seizures) rather than whether her headaches equaled its criteria.
Listing 11.02B requires dyscognitive seizures (or their equivalent) at least once a week for at least three consecutive months despite treatment. Listing 11.02D requires such events at least once every two weeks for three consecutive months plus marked limitation in a functional area.
Multiple providers documented headache frequency that potentially satisfies these equivalence thresholds: neurologist Dr. Ana Patricia Groeschel recorded daily headaches spiking to migraines more than 15 days per month, sometimes lasting several days; Dr. Michael Jordan noted four to six migraines per week with constant headaches since the injury. The ALJ discounted these provider records because he found Lori H-L.'s subjective reports not fully credible — which is precisely the issue being remanded.
Because the step-three analysis is intertwined with the RFC formulation and the SSR 16-3p reassessment, the court remanded for reconsideration of whether Lori H-L.'s headache disorder meets or equals Listing 11.02. The court also noted that the ALJ may have discounted Dr. Jane Bailey's vision-related findings (hyperopia, light sensitivity, tunnel vision, double vision) on an insufficiently supported basis.
Issue 3: Closed Period of Disability
Lori H-L. also argued the ALJ erred by failing to consider whether she was entitled to a "closed period" of disability — a finding that a claimant was disabled for a defined period even if not continuously disabled through the date of decision. The court declined to reach this argument on the current record, but directed the ALJ to consider on remand whether any twelve-month period supported a finding of disability.
Disposition
The court:
- Granted Plaintiff's request for relief (Dkt. No. 6);
- Denied the Commissioner's opposition (Dkt. No. 12); and
- Remanded the case to the Commissioner under sentence four of 42 U.S.C. § 405(g) for further administrative proceedings consistent with the order.
Judgment is to be entered accordingly.
Reviewer note from the AI+
Read the full 23-page opinion on CourtListener, the free public archive maintained by the Free Law Project.