Unreported / Non-Citable
Background
Randy E. applied for Social Security disability insurance benefits, alleging disability beginning in 2017. After multiple administrative proceedings — including an Appeals Council remand specifically directing the administrative law judge (ALJ) to reassess his persistent hernias and resulting limitations — the ALJ on remand again denied benefits. The denial relied in significant part on the ALJ’s rejection of a consultative examination report by Dr. Maximous, who limited the claimant to walking and standing no more than two hours in an eight-hour workday based on Plaintiff’s back pain and coronary artery disease (not his hernias). Randy E. sought judicial review under 42 U.S.C. § 405(g).
The Court’s Holding
The court reversed and remanded. Under the post-2017 regulations (20 C.F.R. § 404.1520c), an ALJ must evaluate medical opinions for supportability and consistency and cannot reject an examining or treating doctor’s opinion as unsupported or inconsistent without an explanation supported by substantial evidence (Woods v. Kijakazi).
The ALJ rejected Dr. Maximous’s opinion as unsupported because the examination findings — normal gait, mild lumbar tenderness, reduced range of motion, normal muscle strength — supposedly did not support the durational limit on standing and walking. The court found that explanation inadequate: the ALJ never explained why those findings actually undercut a two-hour standing-and-walking limit, leaving the court to “guess at the purported inconsistencies.” That is not substantial-evidence reasoning under Brown-Hunter v. Colvin.
The ALJ separately rejected Dr. Maximous’s opinion as inconsistent with the record during “the dates of issue.” But the ALJ’s discussion was a long string of record cites without explanation of how those records contradicted the standing-and-walking limitation. Moreover, Dr. Maximous attributed the limitation to back pain and coronary artery disease, not to hernias, so any inconsistency with hernia-related findings was beside the point.
The court also rejected the implicit timing rationale — that Dr. Maximous’s exam post-dated Plaintiff’s date last insured (DLI). Under Benson v. Kijakazi, when the agency itself orders a post-DLI examination as part of carrying out a remand, rejecting that examination simply because of its timing is improper.
Finally, the court declined to consider the Commissioner’s post hoc argument that Dr. Maximous’s opinion was inconsistent with two other doctors’ assessments, because the ALJ never relied on that rationale. Under Bray v. Commissioner, courts review the ALJ’s actual reasoning, not after-the-fact rationalizations.
Key Takeaways
- Under post-2017 regulations, ALJs must explain medical-opinion rejections in terms of supportability and consistency, supported by substantial evidence — not just recite contrary record cites.
- An ALJ who simply lists portions of the record without explaining how they contradict a medical opinion fails the substantial-evidence test (Brown-Hunter v. Colvin).
- When the agency orders a post-date-last-insured consultative examination as part of a remand, the resulting opinion cannot be rejected on the ground that it post-dates the DLI (Benson v. Kijakazi).
- Courts review the ALJ’s actual reasoning, not the Commissioner’s post hoc rationalizations (Bray v. Commissioner).
- If an ALJ’s rejection of a key medical opinion is unsupported, the resulting RFC determination is not supported by substantial evidence and remand is required.
Why It Matters
This decision is a strong reaffirmation that ALJs must engage with medical-opinion evidence in a meaningful way. Especially after the Appeals Council orders specific reconsideration of a particular impairment, courts will scrutinize the ALJ’s second-bite analysis carefully — and will not accept perfunctory recitations of record cites as substantial evidence.
For Social Security practitioners, the case is a useful template for challenging ALJ rejections of consultative examinations. The Maximous opinion in this case turns out to be the same Dr. Maximous opinion at issue in other recent Central District orders, suggesting an emerging pattern of ALJs in this district struggling to articulate adequate reasons under the post-2017 regulations. For ALJs, the order is a reminder to explicitly tie record evidence to the specific functional limitation being rejected, rather than offering generalized inconsistency narratives.