Lakenisha Dowling v. Commissioner of SSA
986 F.3d 377
| 4th Cir. | 2021Background
- Appellant Lakenisha Dowling received a fully favorable SSA disability decision in 2011 but the SSA found medical improvement and terminated benefits effective March 31, 2013; ALJ affirmed termination in a 2016 decision.
- Appellant suffers from inflammatory bowel disease (ulcerative colitis/Crohn’s), an anal fissure/fistula, and other conditions causing diarrhea, incontinence, pain, fatigue, and concentration problems.
- Treating physician Dr. Rachael Gross (family physician) submitted a May 4, 2015 treating-source statement saying Dowling could not sit for even two hours total in an 8-hour day and frequently had pain interfering with concentration.
- The ALJ gave Dr. Gross’s opinion only “negligible weight,” found Dowling had RFC for sedentary work (with some standing/walking/stooping limits but no sitting limit), and concluded she could perform past relevant work.
- The Fourth Circuit held the ALJ committed reversible legal error by (1) failing to consider each 20 C.F.R. § 404.1527(c) factor before discounting the treating opinion, and (2) using an incorrect RFC framework and failing to perform/describe a required function‑by‑function RFC analysis (notably failing to analyze sitting limitations and need for frequent restroom breaks).
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether ALJ properly weighed treating physician opinion under 20 C.F.R. § 404.1527(c) | ALJ failed to consider all six § 404.1527(c) factors and thus improperly assigned only negligible weight to Dr. Gross’s opinion | ALJ permissibly discounted the opinion as inconsistent with other record evidence showing improvement | Reversed: ALJ erred by not meaningfully considering each § 404.1527(c) factor; remand required to apply factors and explain weight given |
| Whether ALJ used correct RFC framework (function‑by‑function analysis and applicable SSRs/regulations) | ALJ relied on symptom-evaluation SSRs and stated sedentary RFC before function-by-function analysis, failing to follow 20 C.F.R. § 416.945 and SSR 96‑8p | ALJ considered symptoms and medical evidence sufficiently to support RFC and decision | Reversed: ALJ used incorrect framework, failed to perform/describe the required function‑by‑function analysis, and impermissibly began with a conclusion |
| Whether ALJ adequately assessed sitting limitations and need for restroom proximity/frequent breaks | Dowling’s IBD/anal fissure cause contested sitting limitations and unpredictable bathroom needs that could preclude sedentary work | ALJ noted drainage management and other improvements and found no sitting restriction | Reversed: ALJ failed to analyze sitting ability and frequency of bathroom breaks; remand to assess these functions and their effect on RFC |
Key Cases Cited
- Bird v. Commissioner of Social Security, 699 F.3d 337 (4th Cir.) (standard for reviewing ALJ decisions)
- Pearson v. Colvin, 810 F.3d 204 (4th Cir.) (definition of substantial evidence)
- Shinaberry v. Saul, 952 F.3d 113 (4th Cir.) (evidentiary sufficiency threshold)
- Craig v. Chater, 76 F.3d 585 (4th Cir.) (no reweighing evidence on review)
- Arakas v. Commissioner of Social Security, 983 F.3d 83 (4th Cir.) (requirement to consider § 404.1527(c) factors)
- Thomas v. Berryhill, 916 F.3d 307 (4th Cir.) (function‑by‑function RFC analysis and narrative explanation requirement)
- Monroe v. Colvin, 826 F.3d 176 (4th Cir.) (RFC must consider each function)
- Mascio v. Colvin, 780 F.3d 632 (4th Cir.) (no per se rule but function analysis required when contested)
- Patterson v. Commissioner of Social Security, 846 F.3d 656 (4th Cir.) (remand required where procedures prevent meaningful judicial review)
- Cook v. Heckler, 783 F.2d 1168 (4th Cir.) (procedural compliance necessary for review)