Maria Teresa Pupo v. Commissioner, Social Security Administration, 17 F.4th 1054

Background

Maria Teresa Pupo applied for SSI alleging depression, pain, diabetes, hypertension and stress urinary incontinence following prior injuries; ALJ denied benefits in Aug. 2016 and the district court affirmed.
Medical record included ongoing urology/gynecology treatment for stress urinary incontinence and uterine prolapse (wearing multiple pads daily), treatment discussions about surgery, and psychiatric treatment for major depressive disorder and anxiety.
Treating physician Dr. Rolando Diaz completed an RFC questionnaire describing limited walking/sitting tolerance and rare ability to lift 10 pounds; ALJ gave his opinion minimal weight.
ALJ found severe impairments (depression, HTN, hypothyroidism, diabetes, obesity), concluded RFC = medium work with limited contact and simple instructions, and relied on a vocational expert rather than the grids.
Pupo submitted additional records to the Appeals Council showing she underwent surgery for stress incontinence nine days before the ALJ decision; the Appeals Council declined to consider them.
Eleventh Circuit reversed and remanded, holding (1) the ALJ failed to consider the effect of stress urinary incontinence on RFC and (2) the Appeals Council erred in refusing to consider the new evidence of surgery.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Borderline age category at Step Five	ALJ should have considered applying older age category (55) to favor disability	ALJ did not need to because Pupo offered no evidence and ALJ used VE testimony, not mechanical grids	No error; ALJ did not apply the grids mechanically and used VE evidence, so he was not required to treat as borderline age
Appeals Council refusal to consider post‑hearing medical records	Records showing surgery for stress incontinence are new, material, chronologically relevant and could change the outcome	Appeals Council said the evidence would not change the result	Error; evidence was new, material, chronologically relevant and had reasonable probability of changing outcome — remand required
RFC assessment failure to address stress urinary incontinence	ALJ ignored incontinence when assessing physical RFC and lifting limits; did not perform function‑by‑function analysis	ALJ relied on treatment notes and assigned minimal weight to treating opinion; concluded objective evidence supported medium RFC	Error; ALJ failed to consider all impairments (including non‑severe incontinence) and did not support medium RFC with adequate function‑by‑function analysis — remand required
Weight to treating physician opinions and Step Three listings	ALJ erred by not giving controlling weight to treating physician and psychiatrist and by misassessing listed impairments	Commissioner defended ALJ credibility and findings	Court declined to decide these issues on the merits; remanded for full reconsideration on entire record

Key Cases Cited

Moore v. Barnhart, 405 F.3d 1208 (11th Cir. 2005) (standard of review and claimant burden)
Winschel v. Comm’r of Soc. Sec., 631 F.3d 1176 (11th Cir. 2011) (agency burden at Step Five and use of grids)
Walker v. Bowen, 826 F.2d 996 (11th Cir. 1987) (non‑exertional impairments may preclude use of grids)
Reeves v. Heckler, 734 F.2d 519 (11th Cir. 1984) (claimant must show grids should not be applied mechanically)
Wilson v. Barnhart, 284 F.3d 1219 (11th Cir. 2002) (VE testimony must include all impairments)
Gibson v. Heckler, 762 F.2d 1516 (11th Cir. 1985) (description of grids as matrices)
Ingram v. Comm’r of Soc. Sec., 496 F.3d 1253 (11th Cir. 2007) (new evidence may be presented at Appeals Council)
Washington v. Soc. Sec. Admin., Comm’r, 806 F.3d 1317 (11th Cir. 2015) (Appeals Council review standard for new evidence)
Schink v. Comm’r of Soc. Sec., 935 F.3d 1245 (11th Cir. 2019) (ALJ must consider non‑severe impairments in RFC)
Daniels v. Apfel, 154 F.3d 1129 (10th Cir. 1998) (borderline age regulation interpreted to prohibit mechanical grid use)