Michael Winschel appeals the district court’s order affirming the Administrative Law Judge’s (“ALJ”) denial of his application for disability insurance benefits and supplemental security income, pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3), respectively. First, Winschel asserts that the ALJ erred by failing to consider and to specify the weight he accorded to the medical opinions of a treating physician and an examining physician. Second, Winschel contends that the ALJ erred by posing an incomplete hypothetical question to the vocational expert and then by relying on the vocational expert’s response to conclude that there were significant numbers of jobs in the national economy that Winschel could perform. Winschel argues that these errors demonstrate that the ALJ’s denial of benefits was not based on proper legal standards and was not supported by substantial evidence. We agree, and for the following reasons, we reverse and remand.
In Social Security appeals, we must determine whether the Commissioner’s decision is “ ‘supported by substantial evidence and based on proper legal standards. Substantial evidence is more than a scintilla and is such relevant evidence as a reasonable person would accept as adequate to support a conclusion.’ ”
Crawford v. Comm’r of Soc. Sec.,
The Social Security Regulations outline a five-step, sequential evaluation process used to determine whether a claimant is disabled: (1) whether the claimant is currently engaged in substantial gainful activity; (2) whether the claimant has a severe impairment or combination of impairments; (3) whether the impairment meets or equals the severity of the specified impairments in the Listing of Impairments; (4) based on a residual functional capacity (“RFC”) assessment, whether the claimant can perform any of his or her past relevant work despite the impairment; and (5) whether there are significant numbers of jobs in the national economy that the claimant can perform given the claimant’s RFC, age, education, and work experience.
See Phillips,
I.
Winschel first argues that the ALJ’s treatment of medical opinions at the fourth and fifth steps of the sequential evaluation process constitutes reversible error. “Medical opinions are statements from physicians and psychologists or other acceptable medical sources that reflect judgments about the nature and severity
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of [the claimant’s] impairment(s), including [the claimant’s] symptoms, diagnosis and prognosis, what [the claimant] can still do despite impairment(s), and [the claimant’s] physical or mental restrictions.” 20 C.F.R. §§ 404.1527(a)(2), 416.927(a)(2). Absent “good cause,” an ALJ is to give the medical opinions of treating physicians “substantial or considerable weight.”
Leivis,
Moreover, the ALJ must state with particularity the weight given to different medical opinions and the reasons therefor.
Sharfarz v. Bowen,
The Commissioner argues that the ALJ was not required to consider the treating physician’s treatment notes because they did not constitute a “medical opinion,” but this argument ignores the language of the regulations. The treating physician’s treatment notes included a description of Winschel’s symptoms, a diagnosis, and a judgment about the severity of his impairments, and clearly constituted a “statement ] from [a] physician ... that reflectes] judgments about the nature and severity of [Winschel’s] impairment(s), including [Winschel’s] symptoms, diagnosis and prognosis, what [Winschel] can still do despite impairments), and [Winschel’s] physical or mental restrictions.” 20 C.F.R. §§ 404.1527(a)(2), 416.927(a)(2).
In this case, the ALJ referenced Winschel’s treating physician only once, and that reference merely noted that Winschel saw the doctor monthly. The ALJ did not mention the treating physician’s medical opinion, let alone give it “considerable weight.” Likewise, the ALJ did not discuss pertinent elements of the examining physician’s medical opinion, and the ALJ’s conclusions suggest that those elements were not considered. It is possible that the ALJ considered and rejected these two medical opinions, but without clearly articulated grounds for such a rejection, we cannot determine whether the ALJ’s conclusions were rational and supported by substantial evidence. Accordingly, we reverse. On remand, the ALJ must explicitly consider and explain the weight accorded to the medical opinion evidence.
II.
Next, Winschel argues that the ALJ’s finding of no disability is not sup *1180 ported by substantial evidence because the hypothetical question upon which the vocational expert based his testimony omitted Winschel’s moderate limitations in maintaining concentration, persistence, and pace, despite the ALJ’s finding that Winschel’s mental impairments caused such limitations.
At step five, the Commissioner must determine that significant numbers of jobs exist in the national economy that the claimant can perform.
Phillips,
We have never addressed in a published opinion whether a hypothetical question to a vocational expert must specifically account for limitations in concentration, persistence, and pace identified during the Psychiatric Review Technique (“PRT”).
1
The Commissioner contends that to include such limitations in a hypothetical question would inappropriately conflate independent inquiries — the PRT, at steps two and three, and the RFC, at step four. Other circuits have rejected this argument,
see Ramirez v. Barnhart,
Other circuits have also rejected the argument that an ALJ generally accounts for a claimant’s limitations in concentration, persistence, and pace by restricting the hypothetical question to simple, routine tasks or unskilled work.
See Stewart v. Astrue,
In this case, the ALJ determined at step two that Winschel’s mental impairments caused a moderate limitation in maintaining concentration, persistence, and pace. But the ALJ did not indicate that medical evidence suggested Winschel’s ability to work was unaffected by this limitation, nor did he otherwise implicitly account for the limitation in the hypothetical. Consequently, the ALJ should have explicitly included the limitation in his hypothetical question to the vocational expert.
Because the ALJ asked the vocational expert a hypothetical question that failed to include or otherwise implicitly account for all of Winschel’s impairments, the vocational expert’s testimony is not “substantial evidence” and cannot support the ALJ’s conclusion that Winschel could perform significant numbers of jobs in the national economy. Accordingly, we reverse. On remand, the ALJ must pose a hypothetical question to the vocational expert that specifically accounts for Winschel’s moderate limitation in maintaining concentration, persistence, and pace.
REVERSED and REMANDED.
Notes
. We have, however, noted that an ALJ must incorporate the results of the PRT into his findings and conclusions.
See Moore v. Barnhart,