Bell v. Bisignano

CourtDistrict Court, E.D. North Carolina
DecidedJuly 3, 2025
Docket7:24-cv-00842
StatusUnknown

This text of Bell v. Bisignano (Bell v. Bisignano) is published on Counsel Stack Legal Research, covering District Court, E.D. North Carolina primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Bell v. Bisignano, (E.D.N.C. 2025).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF NORTH CAROLINA SOUTHERN DIVISION No. 7:24-CV-00842-D

Amy Bell,

Plaintiff,

v. Memorandum & Recommendation

Frank J. Bisignano, Commissioner of Social Security,1

Defendant.

Plaintiff Amy Bell challenges an Administrative Law Judge’s decision to deny her application for social security income. Bell claims that the ALJ erred in reaching that decision by failing to apply the correct legal standard to evaluate her fibromyalgia. Both Bell and Defendant Frank J. Bisignano, Commissioner of Social Security, seek a decision in their favor. D.E. 15, 17. After reviewing the parties’ arguments, the court has determined that the ALJ erred in his determination. The record fails to support the reasons the ALJ offered to discount Bell’s statements about her fibromyalgia symptoms. The undersigned thus recommends that the court grant Bell relief, deny Bisignano relief, and remand this matter to the Commissioner for further consideration.2

1 The court substitutes Frank J. Bisignano for former defendant Martin J. O’Malley. See Fed. R. Civ. P 25(d).

2 The court has referred this matter to the undersigned for entry of a Memorandum and Recommendation. 28 U.S.C. § 636(b). D.E. 18. I. Background A. Factual3 Bell’s medical history includes migraines, fibromyalgia, and chronic pain. In 2020, Bell visited the Mayo Clinic for aching, constant fatigue, brain fog. Tr. at 406. Providers noted 11 of

18 tender points typical of fibromyalgia. Tr. at 407. They assessed widespread pain suggestive of central sensitization with fibromyalgia features. Id. In January 2021, Bell reported widespread pain of five out of ten in intensity. Tr. at 382. She continued to experience brain fog, significant fatigue, and difficulty sleeping. Id. Providers recommended her for a fibromyalgia treatment program. Tr. at 383. But her insurance would not cover the treatment. Tr. at 370. Providers started Bell on Cymbalta the next month. Id. Dr. Bao Nguyen provided a statement on Bell’s condition in September 2021. Tr. at 840. She did not tolerate Cymbalta well and was taking Prozac and Lyrica. Id. Fibromyalgia caused issues with Bell’s cognition and memory. Id. And she napped frequently because of pain and fatigue. Id.

At a visit to Vidant Health six months later, Bell again reported fatigue, widespread pain, and cognitive issues. Tr. at 1331. Treatment notes reflect she had nine positive tender points for fibromyalgia at a return visit in June 2022. Tr. at 1378. Providers advised her how her worsening pain and fatigue symptoms may impact other body systems. Tr. at 1695. In April 2023, an MRI showed disc herniations at L5-S1, with a mass effect on the exiting nerve roots and moderate stenosis. Tr. at 21. It also revealed a small central disc protrusion at C5- C6. Id.

3 Bell’s brief focuses on the ALJ’s consideration of her fibromyalgia. So the court will concentrate its recapitulation of the factual background to the evidence relating to that condition. Around this time, Bell attended physical therapy for an evaluation of her chronic pain and fibromyalgia. Tr. at 1846. She reported daily pain and numbness in her feet. Id. Providers noted pain, an abnormal gait, and decreased walking tolerance. Tr. at 1849. With an unstable presentation and unpredictable features, her potential for rehabilitation was fair. Id.

The following month, Bell reported some benefit from Lyrica. Tr. at 1772. But she continued to experience constant pain, rated as seven out of ten in intensity, with her feet most affected. Id. Providers noted 16 positive tender points. Tr. at 1773, 1776. At a return visit the next month, Bell reported daily flares, rating her pain as eight out of ten. Tr. at 1766. Providers noted an antalgic gait and 16 positive tender points. Tr. at 1769–70. It was unclear if Lyrica provided any benefit. Tr. at 1770. Providers remarked that prior testing had not yielded definite causes of Bell’s continued pain and neurological symptoms. Tr. at 21. But there was no evidence of inflammation or an autoimmune or connectivity disease. Id. Although her symptoms tracked pain processing issues and fibromyalgia, records note that Bell had difficulty believing it. Tr. at 22. And there was a

“component of catastrophication” that complicated her prognosis. Id. From a mental health standpoint, Bell suffered from anxiety, for which providers prescribed medication. Id. A September 2021 mental status examination showed normal attention, memory, and judgment, with stable anxiety. Id. Six months later, Bell reported worsening anxiety from emotional distress. Id. She was experiencing issues with memory, cognition, and concentration. Id. But a mental status examination was unremarkable, showing normal memory and concentration. Id. Providers assessed an anxiety disorder. Id. Because of her ongoing reports of memory and cognition issues, Bell had a neuropsychiatric assessment in June 2022. Id. She responded to instructions at a medium pace, but had a slow to medium pace when completing tasks. Id. But she had not taken her Adderall that day. Id. Bell appeared somewhat irritable and had some negative remarks about her performance.

Id. And she claimed that she limited social events and disliked being around people. Id. The examiner noted that Bell reported a larger than average number of somatic symptoms along with an unusual combination of responses. Id. So there were credibility issues with her memory and cognition symptoms. Id. The examiner assessed an anxiety disorder and attention- deficit hyperactivity disorder (ADHD). Id. Bell reported limitations in her abilities to sit, stand, walk, use her hands, and perform postural movements, as well as remembering, understanding, and concentrating. Tr. at 20. She experiences pain, numbness, and a pins and needles sensation in her feet. Tr. at 60. Bell can drive and perform light chores but needs help with personal care. Tr. at 21. She estimated that she can stand for about 15 minutes and carry around five pounds. Tr. at 51, 55.

B. Procedural In March 2021, Bell protectively applied for disability benefits alleging a disability that began three months earlier. After the Social Security Administration denied her claim at the initial level and upon reconsideration, Bell appeared for a telephonic hearing before an ALJ to determine whether she was entitled to benefits. The ALJ determined Bell had no right to benefits because she was not disabled. Tr. at 14–26. The ALJ found that Bell lived with several severe impairments. Among these were fibromyalgia, meningioma, degenerative disc disease, migraines, generalized anxiety disorder (GAD), and attention-deficit hyperactivity disorder (ADHD). Tr. at 17. The ALJ also found that Bell’s impairments, either alone or in combination, did not meet or equal a Listing impairment. Id. Next, the ALJ determined that Bell had the residual functional capacity (RFC) to perform light work with other limitations. Tr. at 19–20. She can read ordinary newspaper or book print. Id.

1401. Bell can frequently climb ramps and stairs and occasionally climb ladders, ropes, and scaffolds. Id. And she can balance frequently. Id. Bell can work in moderate noise and occasionally work at unprotected heights, with moving mechanical parts, and in extreme heat. Id. She can understand, remember, and carry out instructions by performing simple, routine, and repetitive tasks but not at a production rate pace (e.g., assembly-line work). Id. Bell can use her judgment to make simple, work-related decisions. Id. And she can frequently interact with supervisors and occasionally interact with coworkers and the public. Id. Then the ALJ concluded that Bell could not perform her past relevant work as a special education teacher.

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Bell v. Bisignano, Counsel Stack Legal Research, https://law.counselstack.com/opinion/bell-v-bisignano-nced-2025.