Jose M. v. Frank Bisignano, Commissioner of Social Security

District Court, E.D. Washington·Decided May 11, 2026·No. 4:25-cv-05141·Unknown

Opinion

May 11, 2026

SEAN F. MCAVOY, CLERK

EASTERN DISTRICT OF WASHINGTON

JOSE M.,1 No. 4:25-cv-5141-EFS

Plaintiff, ORDER REVERSING THE v. ALJ’S DENIAL OF BENEFITS, AND REMANDING FOR Commissioner of Social Security, Defendant.

Plaintiff Jose M. asks the Court to reverse the Administrative Law Judge’s (ALJ) denial of Title 16 benefits. Plaintiff claims he is unable to work due to several physical and mental impairments. The

1 For privacy reasons, Plaintiff is referred to by first name and last initial or as “Plaintiff.” See LCivR 5.2(c). ALJ determined that Plaintiff could perform sedentary-exertional jobs

with some non-disabling mental limitations. Substantial evidence does not support the ALJ’s evaluation of the two consulting psychiatric opinions in the record. These errors impacted the nondisability

determination. This matter is remanded for further proceedings. I. Background Plaintiff filed his Title 16 application for benefits on August 12,

2022, alleging disability due to several conditions, including conditions resulting from a gunshot wound and operations to his foot, chronic pain, diabetes, and anxiety.2 ALJ Nathaniel Plucker held a hearing in

October 2024, at which Plaintiff and a vocational expert testified.3 Plaintiff testified that as a result of multiple surgeries to his foot, complications from diabetes, and back pain, he used a cane to walk,

spent most of his day seated or lying down, and had a caregiver from

2 Administrative Record (AR) 220. Because the application filing date starts the relevant period for Title 16 claims, the ALJ appropriately considered whether Plaintiff was disabled beginning August 12, 2022. 3 AR 43–84. the State who assisted him with living tasks.4 He testified that due to

severe anxiety, he isolated at home, could not be around crowds, was frequently agitated and paranoid, and had attention and memory problems.5 The vocational expert testified that a hypothetical

individual who could perform sedentary work with certain physical, postural, and environmental limitations could perform some jobs, but the same individual with additional training, social, and attention

limitations could not adjust to competitive employment.6 Following the hearing, the ALJ issued a decision in December 2024 finding Plaintiff not disabled.7 The ALJ found Plaintiff’s alleged

symptoms were inconsistent with the medical evidence and other evidence.8 The ALJ considered the lay statements from Plaintiff’s

4 AR 56–77. 5 AR 64, 66, 74–77. 6 AR 78–82. 7 AR 18–32. Per 20 C.F.R. § 416.920(a)–(g), a five-step evaluation determines whether a claimant is disabled. 8 AR 25. mother, who submitted a third-party statement consistent with

Plaintiff’s hearing testimony.9 As to the medical opinions, the ALJ found: • the reviewing opinion of Wayne Hurley, MD, partially

persuasive. • the examining opinions of Leslie Smith, PMHNP, Marquetta Washington, ARNP, and Jacob Franco, PMHNP, partially

persuasive. • the treating opinion of Jesus Marcelo, MD, not persuasive. • the opinion of case manager Ken Owens not persuasive.

• the reviewing opinions of Dennis K., MD, John W., PhD, and Beth Fitterer were not considered because of incomplete author names and credentials.10

As to the sequential disability analysis, the ALJ found: • Step one: Plaintiff had not engaged in substantial gainful activity since August 12, 2022, the application date.

9 AR 30, 321. 10 AR 27–30. • Step two: Plaintiff had the following medically determinable

severe impairments: residuals of a gunshot wound to the left foot with multiple surgeries; diabetes mellitus; lumbar degenerative disc disease; obesity; and generalized anxiety

disorder. • Step three: Plaintiff did not have an impairment or combination of impairments that met or medically equaled the

severity of one of the listed impairments. • RFC: Plaintiff had the RFC to perform “sedentary work” as defined in 20 C.F.R. § 416.967(a) except he could not climb

ladders, ropes, or scaffolds; could occasionally climb stairs and ramps; could occasionally stoop, kneel, crouch, and crawl; needed to use a cane when ambulating; must avoid exposure to

vibration and hazards; was limited to work involving simple, routine tasks and simple work-related decisions; could occasionally interact with coworkers and supervisors; could

never interact with the public; and could not perform fast- paced work such as work on an assembly line. • Step four: Plaintiff had no past relevant work.

• Step five: considering Plaintiff’s RFC, age, education, and work

history, Plaintiff could perform work that existed in significant numbers in the national economy, such as optical goods assembler, circuit board screener, and machine tender.11

Plaintiff timely requested review of the ALJ’s decision by the Appeals Council, which denied review.12 Plaintiff now appeals to district court.13

II. Standard of Review The ALJ’s decision is reversed “only if it is not supported by substantial evidence or is based on legal error”14 and such error

impacted the nondisability determination.15 Substantial evidence is

11 AR 20–31. 12 AR 1. 13 ECF No. 1. 14 Hill v. Astrue, 698 F.3d 1153, 1158 (9th Cir. 2012). See 42 U.S.C. § 405(g). 15 Molina v. Astrue, 674 F.3d 1104, 1115 (9th Cir. 2012), superseded on other grounds by 20 C.F.R. § 416.920(a) (recognizing that the court may “more than a mere scintilla but less than a preponderance; it is such

relevant evidence as a reasonable mind might accept as adequate to support a conclusion.”16 III. Analysis

Plaintiff argues the ALJ committed four consequential errors: (1) improperly evaluated the medical opinion evidence; (2) inadequately evaluated the lay witness testimony; (3) erroneously rejected Plaintiff’s

subjective complaints; and (4) failed to meet the ALJ’s burden at step

not reverse an ALJ decision due to a harmless error—one that “is inconsequential to the ultimate nondisability determination”). 16 Hill, 698 F.3d at 1159 (quoting Sandgathe v. Chater, 108 F.3d 978, 980 (9th Cir. 1997)). See also Lingenfelter v. Astrue, 504 F.3d 1028, 1035 (9th Cir. 2007) (The court “must consider the entire record as a whole, weighing both the evidence that supports and the evidence that detracts from the Commissioner’s conclusion,” not simply the evidence cited by the ALJ or the parties.) (cleaned up); Black v. Apfel, 143 F.3d 383, 386 (8th Cir. 1998) (“An ALJ’s failure to cite specific evidence does not indicate that such evidence was not considered[.]”). five.17 The Commissioner argues that Plaintiff’s challenges amount to

an improper request to reweigh the evidence, that the ALJ committed no consequential error, and that substantial evidence supports the ALJ’s decision.

A. Medical Opinions: Plaintiff establishes consequential error. Plaintiff argues the ALJ erred in his evaluation of the mental-

health opinions from NP Smith, NP Franco, and Mr. Owens, and the physical-health opinion from Dr. Marcelo, by failing to properly consider the consistency and supportability of those opinions. As is

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Jose M. v. Frank Bisignano, Commissioner of Social Security, (E.D. Wash. 2026).

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