Tiffany B. v. Frank Bisignano, Commissioner of Social Security

District Court, E.D. Washington·Decided May 11, 2026·No. 1:25-cv-03174·Unknown

Opinion

FILED IN THE U.S. DISTRICT COURT EASTERN DISTRICT OF WASHINGTON May 11, 2026 SEAN F. MCAVOY, CLERK EASTERN DISTRICT OF WASHINGTON TIFFANY B.,1 No. 1:25-cv-3174-EFS Plaintiff, ORDER REVERSING THE v. ALJ’S DENIAL OF BENEFITS, AND REMANDING FOR Commissioner of Social Security, Defendant. Plaintiff Tiffany B. asks the Court to reverse the Administrative Law Judge’s (ALJ) denial of Title 2 and Title 16 benefits because the ALJ erred when evaluating the medical opinions. The ALJ so erred, 1 For privacy reasons, Plaintiff is referred to by first name and last initial or as “Plaintiff.” See LCivR 5.2(c). and this error affected the crafted residual functional capacity.

Therefore, this matter is remanded for further proceedings, including a new physical consultative examination. I. Background

Plaintiff filed applications for benefits, alleging disability beginning December 7, 2021, due to several conditions, including Ehlers-Danlos syndrome, small fiber autonomic neuropathy,

dysautonomia, dysphagia, and chronic pain syndrome.2 In November 2024, Plaintiff appeared for a hearing before ALJ Kathryn Preston.3 Plaintiff, who was then 33-years-old, testified that she experiences

chronic pain throughout her body, including her neck, back, shoulders, hips, legs, and arms, along with burning and tingling sensations, and at times numbness, in her hands and legs.4 She stated that she

experiences tremors and hand spasms when engaging in repetitive hand activities, she has heart palpitations or fainting episodes, her

2 Administrative Record (AR) 207–33, 271. 3 AR 36–59. 4 AR 46, 53. pain limits her ability to stand to about 5 minutes at a time, and she

must change positions often.5 She testified that due to pain she has decreased cognitive abilities, requiring her to write down instructions.6 She stated that she is no longer taking medications, as none of the

medications helped reduce her pain by more than 20 percent, and so the medication side effects were not worth taking the medication.7 She stated that, at the suggestion of her physical therapist, she uses a

three-point cane with a folding seat, which allows her to sit and rest when she is walking.8 She stated that she can drive and that she lives with her mother, who helps her shower.9

On function reports, Plaintiff likewise reported pain when sitting, standing, or lifting; difficulties showering by herself due to fatigue, weakness, and shoulder pains; the need to set reminders on her phone

5 AR 46. 6 AR 46. 7 AR 46–47. 8 AR 47–48. 9 AR 45–50. to remember to do things; and difficulty with following spoken

instructions.10 She listed that she has uses walking sticks and bracing for her hands, knees, elbows, ankles, feet, and neck.11 After the hearing, the ALJ issued a decision finding Plaintiff not

disabled.12 The ALJ found Plaintiff’s alleged symptoms were “not entirely consistent with the medical evidence and other evidence.”13 As to the medical opinions, the ALJ found:

• the prior administrative medical findings of the state agency medical consultants, Ken Murphy, MD, and Thomas Davenport, MD, persuasive except for their opinion that

10 AR 288–89, 292, 307–08, 309–10. 11 AR 293. 12 AR 14–35. Per 20 C.F.R. §§ 404.1520(a)–(g), 416.920(a)–(g), a five- step evaluation determines whether a claimant is disabled. 13 AR 24. As recommended by the Ninth Circuit in Smartt v. Kijakazi, the ALJ should consider replacing the phrase “not entirely consistent” with “inconsistent.” 53 F.4th 489, 499, n.2 (9th Cir. 2022). Plaintiff be limited to 4 hours of standing/walking in a

workday. • the prior administrative medical findings of the state agency psychological consultants, Elizaeth Cucolo, PsyD, and Susan

South, PsyD, “somewhat persuasive.” • The examining physical consultative examination of Shari Engstrom, MD, “somewhat persuasive.”

• The treating physical opinion of Amy Madison, MD, not persuasive.14 As to the sequential disability analysis, the ALJ found:

• Plaintiff meets the insured status requirements through December 31, 2026. • Step one: Plaintiff had not engaged in substantial gainful

activity since December 17, 2021, the alleged onset date. • Step two: Plaintiff had the following medically determinable severe impairments: major depressive disorder, generalized

anxiety disorder, post-traumatic stress disorder, chronic pain

14 AR 26–28. syndrome, Ehlers-Danlos syndrome, migraine, chronic fatigue

syndrome, lumbar degenerative disc disease, lumbar radiculopathy, autonomic neuropathy, cervical degenerative disc disease, obesity, and postural orthostatic tachycardia

syndrome. • 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 a range of light work and:

[T]he claimant is able to lift up to 20 pounds occasionally and lift/carry up to ten pounds frequently. She is able to stand/walk for about six hours and sit for up to six hours in an eight-hour workday, with normal breaks. She is unable to climb ladders/ropes/scaffolds, but is occasionally able to climb ramps/stairs, balance, stoop, kneel, crouch, and crawl. She is unable to tolerate exposure to unprotected heights and use of dangerous moving machinery. She is able to perform simple, routine, and repetitive tasks in a work environment free of production-rate pace requirements, involving only simple work-related decisions and routine workplace changes. She is able to engage in frequent bilateral handling and fingering.

• Step four: Plaintiff is unable to perform 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 office helper, marker, and electronics worker.15

Plaintiff requested review of the ALJ’s decision by the Appeals Council, which denied review.16 Plaintiff now appeals to district court.17

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”18 and such error

impacted the nondisability determination.19 Substantial evidence is

15 AR 17–30. 16 AR 1–6. 17 ECF No. 1. 18 Hill v. Astrue, 698 F.3d 1153, 1158 (9th Cir. 2012). See 42 U.S.C. § 405(g). 19 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.”20 III. Analysis

Plaintiff argues the ALJ made conclusory findings that are not supported by substantial evidence when discounting the medical opinions of Dr. Madison and Dr. Engstrom. In response, the

Commissioner argues that, when her entire decision is considered, the

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Tiffany B. v. Frank Bisignano, Commissioner of Social Security, (E.D. Wash. 2026).

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