Vang v. O'Malley

U.S. District Court, District of Minnesota March 28, 2024

Trial Court Opinion

                UNITED STATES DISTRICT COURT                            
                   DISTRICT OF MINNESOTA                                


Mai V.,                              Case No. 22-CV-2086 (JFD)          

              Plaintiff,                                                

v.                                          ORDER                       

Martin J. O’Malley, Commissioner of                                     
the Social Security Administration,                                     

              Defendant.                                                


   Pursuant to

42 U.S.C. § 405

(g), Plaintiff Mai V. seeks judicial review of a final
decision by the Commissioner of the Social Security Administration, which denied the
Plaintiff’s applications for disability insurance benefits (“DIB”) and supplemental security
income (“SSI”). The case is before the Court on Plaintiff’s Brief requesting that the
Commissioner’s decision be reversed and the matter remanded to the Social Security
Administration (Dkt. No. 12) as well as the Commissioner’s Motion for Summary
Judgment requesting that the decision be affirmed (Dkt. No. 15). Plaintiff argues that the
administrative law judge (“ALJ”) who issued the written decision erred in two respects.
First, Plaintiff contends that the ALJ did not fully account for the residual effects of
Plaintiff’s strokes in assessing her residual functional capacity (“RFC”). Second, Plaintiff
asserts that the ALJ did not properly evaluate medical opinion evidence. Defendant
opposes Plaintiff’s arguments and asks the Court to affirm the final decision. As set forth
below, the Court concludes that the ALJ erred in both respects, and the Court therefore
reverses the Commissioner’s decision and remands the matter for further administrative
proceedings.

I. Background
Plaintiff applied for DIB and SSI on February 28, 2020, alleging she has been
disabled since October 7, 2019. (See Soc. Sec. Admin. R. (hereinafter “R.”) 53.)1 Her
alleged impairments were moyamoya disease, strokes, cerebrovascular accident,
hypothyroidism, type 2 diabetes, peer hyper cholesterol, diabetic neuropathy, left carotid
stenosis, mood disorder, and adjustment disorder with mixed anxiety and depressed mood.

(R. 52–53.)
A. Relevant Evidence
“Moyamoya disease is a rare, progressive cerebrovascular disorder caused by
blocked arteries at the base of the brain in an area called the basal ganglia.” National
Institute of Neurological Disorders and Stroke, https://www.ninds.nih.gov/health-

information/disorders/moyamoya-disease (last visited Mar. 21, 2024). Adults with
moyamoya disease may experience symptoms of “stroke or recurrent transient ischemic
attacks (TIAs), also known as ‘mini-strokes,’ that are frequently accompanied by muscular
weakness or paralysis affecting one side of the body,” “hemorrhagic stroke due to bleeding
into the brain,” headaches, seizures, disturbed consciousness, involuntary movements,

vision problems, and cognitive or sensory impairment.

Id.

1 The administrative record is filed at Dkt. No. 11. The record is consecutively paginated,
and the Court cites to that pagination rather than ECF number and page.
A summary of some evidence preceding the alleged onset-of-disability date of
October 7, 2019, is helpful for context. In early November 2018, Plaintiff was admitted to

an emergency room after experiencing sudden left arm and leg weakness. (R. 440.)
Imaging confirmed a right middle cerebral artery (“MCA”) territory stroke, consistent with
moyamoya disease. (R. 473.) A history of prior left MCA territory strokes was also noted.
(R. 463.) When Plaintiff was discharged after four days to a rehabilitation center, she was
not at her baseline level of functionality, but demonstrated mild to moderate impairments
and limitations, needed assistance to use a walker, and was fatigued by a physical therapy

session. (R. 477.)
Plaintiff saw provider Sarah Hammes, M.D., 10 days after the November 2018
stroke. (R. 590.) Dr. Hammes wrote that the stroke was Plaintiff’s second stroke2 and was
likely related to moyamoya disease. After Plaintiff’s stroke in 2017, she had been advised
to have a stent placed by neurosurgery, but she did not follow up for several reasons,

including scheduling difficulties, lack of insurance, and language difficulties. (R. 315,
590.) Plaintiff speaks Hmong, but her ability to read or write Hmong is spotty. (R. 39, 239.)
She does not speak, read, or write English. (R. 39.) On examination, Dr. Hammes observed
that Plaintiff could walk around the room with equal movement, strength, and coordination
of the upper and lower extremities. (R. 592.) Dr. Hammes recorded similar neurological

findings in December 2019. (R. 603.) Dr. Hammes wrote that Plaintiff seemed confused at
the November 2018 appointment, and at the December 2019 appointment, Plaintiff did not

2 The November 2018 stroke was likely Plaintiff’s third stroke. Plaintiff reported having
her first stroke in 2013 and a second stroke in 2017. (R. 642.)
always understand the doctor’s questions and an interpreter had to explain things several
ways. (R. 592, 603.)

At a medication management appointment in February 2020, Plaintiff reported low
drive and poor sleep. (R. 615.) She also reported tingling on her left side and said she had
recently fallen four times in one day. (R. 617.)
In October 2020, Ward Jankus, M.D., conducted a consultative examination of
Plaintiff. (R. 642.) Plaintiff reported having strokes in 2013, 2017, and 2018. (R. 642.)
Plaintiff told Dr. Jankus that her left leg felt heavy at times and that her left hand was

slower than her right hand. (R. 642.) Plaintiff estimated that her left hand, arm, foot, and
leg had about 80% of the strength and functioning of her right hand, arm, foot, and leg. (R.
643.) On examination, Dr. Jankus observed that Plaintiff’s reflexes were symmetric,
strength was symmetric and a 5/5, and gait was smooth. (R. 644.) Dr. Jankus observed a
“trace” amount of clumsiness and weakness in her left hand, but no severe fine motor

issues. (R. 644.) Dr. Jankus thought Plaintiff “seems to have made a pretty good recovery”
but did not doubt that her left arm and leg were not 100%. His impression was a history of
strokes, “with residual subjective left arm and leg weakness/coordination issues.” (R. 644.)
To account for the risk of falling, Dr. Jankus recommended that she avoid unprotected
heights, ladders, and uneven surfaces. (R. 645.) Regarding Plaintiff’s estimation of 80%

functionality in her left arm, hand, and leg, Dr. Jankus commented that “perhaps something
in that range is pretty realistic.” (R. 645.)
Plaintiff returned to Dr. Hammes for another appointment in November 2020.
Plaintiff reported numbness and tingling in the left hand, left-side weakness, and difficulty
swallowing. (R. 656.) Dr. Hammes wrote that Plaintiff had not followed up on the referral
to neurology or taken her diabetes medication as prescribed. (R. 654.) Dr. Hammes also

noted that Plaintiff’s depression was not well managed and that she was at a high risk of
stroke due to lack of follow-up and inconsistencies in taking medication. (R. 654.) The lack
of follow-up was due in part to “insurance lapses.” (R. 654.) A physical examination
confirmed that Plaintiff’s left-hand grip was weaker than her right-hand grip and that
Plaintiff had numbness and tingling in her left hand. (R. 657.) Plaintiff moved slowly from
a chair to the examining table, but her gait was steady. (R. 657.)

Plaintiff had another stroke shortly after seeing Dr. Hammes, on December 23,
2020. (R. 882.) Dr. Hammes completed a Medical Source Statement on January 18, 2021,
less than one month later. Dr. Hammes opined that, in an 8-hour workday, Plaintiff could
lift and carry no more than 20 pounds occasionally with her right arm only, lift and carry
no more than 10 pounds frequently with her right arm only, stand and walk about 2 hours,

and sit for about 4 hours. (R. 1027.) Plaintiff could sit for 20 minutes before needing to
change positions and could stand for 15 minutes before needing to change positions. (R.
1028.) She would have to walk around every 15 minutes for up to 5 minutes at a time. (R.
1028.) She would also need to shift at will from sitting, standing, or walking, and would
need to lie down at unpredictable intervals every two to four hours due to fatigue, dizziness,

and pain. (R. 1028.) Dr. Hammes listed the underlying conditions and medical findings as
“MoyaMoya causing blockage & Ischemic Strokes in multiple blood vessels of the brain
on both sides.” (R. 1028.) Dr. Hammes opined that Plaintiff could never stoop, crouch,
climb ladders, or use repetitive foot controls with her left foot; that Plaintiff could
occasionally twist, climb stairs, rotate her neck, and flex her neck; and that Plaintiff could
frequently use repetitive right-foot controls. (R. 1029.) Plaintiff’s abilities to reach, handle,

finger, feel, push, and pull would be affected by her impairments; she could never handle
or finger with her left hand; and she could occasionally handle or finger with her right. (R.
1029.) Dr. Hammes attributed the restrictions to left-sided weakness and stiffness from
strokes and identified an MRI as supporting evidence. (R. 1029.)
After Plaintiff’s December 2020 stroke, she had frequent home care visits for
nursing, physical therapy, occupational therapy, and other services in January and

February. A home-care-visit record dated February 17, 2021, when Plaintiff was
discharged from services, documented a recommendation for outpatient therapy for right-
side weakness and limited abilities to dress and bathe. (R. 707, 711.)
Plaintiff saw Dana Peterson, a CNP in neurology, on February 18, 2021. (R. 704.)
Plaintiff reported having left-side weakness since her 2018 stroke, and even more weakness

since the December 2020 stroke; blurry vision in both eyes; and the same amount of
numbness in her left side as before the stroke. (R. 704.) She denied headaches or dizziness.
(R. 704.) On examination, Ms. Peterson observed full strength on the right side, but
weakness, reduced coordination, reduced sensation, and reduced strength on the left side.
(R. 704.) Due to Plaintiff’s “multiple strokes related to worsening stenosis,” Ms. Peterson

recommended bypass surgery. (R. 704.)
In March 2021, Plaintiff told Dr. Hammes that she had a tingling sensation in her
left hand and feet; walking was painful; and stiffness impaired her abilities to move and
walk. (R. 695–96.) Plaintiff reportedly had fallen several times in recent months and was
interested in using a cane. (R. 696.) Plaintiff walked with a limp and held on to her husband
for assistance. (R. 697.) Dr. Hammes recorded “significant left side[] weakness and

stiffness” in Plaintiff’s upper and lower extremities. (R. 697.) The doctor also remarked
that Plaintiff frequently deferred to her husband to answer questions and wondered whether
Plaintiff did not know the answer or had trouble finding the words to answer. (R. 697.)
Plaintiff wanted to discuss Ms. Peterson’s recommendation for bypass surgery with her
family. (R. 694.)

B. Procedural History
Plaintiff’s DIB and SSI applications were denied at both the initial review and
reconsideration stages. She requested an administrative hearing before an ALJ, and the
hearing took place on June 22, 2021. (R. 33.) Plaintiff and a vocational expert, Ms.
Spielman, testified at the hearing. The hearing was conducted by telephone because of the
COVID-19 pandemic. (R. 36, 184.) A Hmong interpreter translated portions of the

proceeding. (R. 35–36.)
Plaintiff testified in relevant part that she could not work because of symptoms
resulting from her strokes, namely weakness in her left hand and arm. (R. 40.) Plaintiff
testified that her left hand was “pretty much completely paralyzed,” and she could not even
button a shirt or hold a coffee cup with her left hand. (R. 41.) Plaintiff has never driven a

car. (R. 39.) Plaintiff testified that her left-hand limitations dated back to November 2019.
(R. 41.) At that point, the interpreter spoke up to clarify what Plaintiff had just said.
INT: The interpreter just needs to clarify that part.
A You’re saying that since the last -- the second stroke, is that
correct?[3] Yes. Since the last stroke, the second stroke that I had, I cannot be
able to do anything, anymore.[4]

Q Okay. So, before that second stroke, were you having any
difficulties using your left hand?

A Yes. Before the second stroke, I still had the movement, too.
So, I’d been working really hard to -- regaining its function. But after the
second stroke, I just cannot be able to use it anymore.

(R. 42.)
The ALJ then asked Plaintiff how she had spent her days before the December 2020
stroke, to which Plaintiff responded that she mostly sat around but could do some minor
dishwashing, sweeping, grocery shopping, and running errands. (R. 43.) Through the
interpreter, Plaintiff testified that, “prior to the second stroke, I’d still be able to function.
I’d still be able to go and do those stuff,” referring to grocery shopping and running errands.
(R. 43.) Plaintiff’s representative then asked Plaintiff to recall when she stopped working
as a personal care assistant in October 2019. (R. 44.)

3 As noted above, Plaintiff had four strokes, in 2013, 2017, 2018, and 2020. The use of
“first” and “second” strokes in the hearing transcript is confusing and seem to be references
to the 2018 and 2020 strokes, which are actually Plaintiff’s third and fourth strokes. This
is not harmless. As will be seen further on in this Order, confusion about which stroke is
which eventually led the ALJ to think Dr. Hammes’ opinion evidence related to a period
of only one month, which would mean Plaintiff’s disability had not lasted 12 months, as
required for a finding of disability under the social security regulations. Dr. Hammes’
opinion evidence actually referred to a period of more than two years.

4 This answer, as reflected on the transcript, actually combines the interpreter’s question
with Plaintiff’s answer. It is clear from the context that the interpreter asked, “You’re
saying that since the last -- the second stroke, is that correct?” Plaintiff then answered,
“Yes. Since the last stroke, the second stroke that I had, I cannot be able to do anything,
anymore.”
Q Okay, because that’s when you had a stroke.[5] So, after your
first stroke, were you having any problems using your left hand, at all?

INT: Counsel, you’re talking about the first stroke, or the second
stroke?

REP: The first one.

A No issue.

Q Okay. Then why did you stop working as a PCA?

A Well, because of my stroke. I cannot help myself. . . . That’s
why I stopped working.

Q Okay. Why couldn’t you help yourself after the first stroke?
What was it that was going on with you, that prevented you from helping
yourself?

A So, after going to the hospital, coming back, I was pretty much
paralyzed. I’m not able to help myself and such. That’s the reason.

Q That was after the first stroke?

A Yes.

Q And how long did that last?

A That’s not been improving. I really want it to get better, but
things just getting worse, and going downhill since then.

Q But did you make some improvement after your first – between
your first stroke and your second stroke?

A No change. It seems like it’s just getting bigger and bigger.

Q Okay. One more clarifying question. After your first stroke,
you testified to being able to go to the grocery store, and do things that you
weren’t able to do after the second stroke. Is that correct?

A Yes. That’s correct.

5 There is no record of Plaintiff having a stroke in or around October 2019.
Q Okay. So I want to hone in on – you said you weren’t able to
take care of yourself after the first stroke. But you were able to go to the
grocery store, and you were able to do some sweeping? But -- so, what
limitations did you have after the first stroke?

A The problems -- the biggest problem is after the second stroke.
That’s when I could not be able to do anything. I feel like I’m going to
fainted, if I move it about.

(R. 44–45.)
The hearing then proceeded to testimony from the vocational expert, Ms. Spielman.
The ALJ asked Ms. Spielman to consider a hypothetical person of Plaintiff’s age and
experience, who, in relevant part, could lift or carry 20 pounds occasionally and 10 pounds
frequently, could stand or walk for 4 hours in an 8-hour workday, could sit for 6 hours in
a workday, could occasionally climb ladders or scaffolds, could not balance in the context
of working at unprotected heights, could do simple and routine tasks, could have occasional
brief and superficial contact with coworkers and the public, could not work in a fast-paced
or high-production-goal environment such as on an assembly line, and could not constantly
handle, finger, or reach. (R. 47–48.) With these limitations, Ms. Spielman testified, the
person could work as a small products assembler, inspector, hand packager, or garment
sorter. (R. 48.) If a limitation to no use of the left hand were added, however, the person
could not work in any occupation. (R. 50–51.)
The ALJ issued a written decision on August 20, 2021, concluding that Plaintiff was
not disabled. (R. 10–27.) The ALJ followed the familiar five-step sequential analysis
outlined in

20 C.F.R. §§ 404.1520

 and 416.920. At each step, the ALJ considered whether 
Plaintiff was disabled based on the criteria of that step. If she was not, the ALJ proceeded 
to the next step. See

20 C.F.R. §§ 404.1520

(a)(4), 416.920(a)(4).

The ALJ first determined that Plaintiff had not engaged in substantial gainful
activity since the alleged onset date of October 7, 2019. (R. 15.) At the second step of the
sequential analysis, the ALJ found that Plaintiff had the following severe impairments:
obesity, diabetes, “cerebrovascular accident due to moyamoya disease,” depression, and
anxiety. (R. 15.) At step three, the ALJ concluded that Plaintiff’s impairments did not meet
or medically equal the severity of an impairment listed in 20 C.F.R. Part 404, Subpart P,

Appendix I. (R. 15.) In the step-three discussion, the ALJ specifically found that Plaintiff’s
December 2020 stroke was not a severe impairment:
The claimant testified to no left hand limitation prior to her stroke in
December 2020, so the undersigned finds that there are no left hand limits in
the residual functional capacity, as there is no 12-month duration supporting
left hand limitations. In addition, no provider opined an expectation of left
hand limitations [that] existed or are expected to exist for 12 months. Overall,
her December 2020 stroke with residual effects is not a severe impairment
due to no 12-month duration or expectation of any limits from it for a 12-
month duration. Thus, the December 2020 stroke and its specific effects do
not further limit the residual functional capacity.

(R. 16.)
Before proceeding to step four, the ALJ assessed Plaintiff’s RFC, which is a
measure of “the most [she] can still do despite [her] limitations.”

20 C.F.R. §§ 404.1545

(a)(1), 416.945(a)(1). As part of the RFC assessment, the ALJ considered
Plaintiff’s statements about the intensity, persistence, and limiting effects of her symptoms
and whether the statements were consistent with the objective medical evidence and other
evidence in the record. (R. 20.) In considering Plaintiff’s testimony, the ALJ wrote,
“Although she initially asserted she could not work due to left arm and hand weakness, she
testified that this was only the case after her December 2020 stroke.” (R. 20.) The ALJ also

recalled Plaintiff’s medical record as containing “a history of strokes with recovery of
function as set forth in the treatment records, although she is a bit more limited since the
later 2020 stroke.” (R. 20.) The ALJ took note of Plaintiff’s failure to follow through with
surgery and to take her medication as prescribed, but also acknowledged lapses in
insurance coverage. (R. 22.) To address “a longstanding degree of left side weakness,” the
ALJ limited Plaintiff’s standing and walking to four hours in an eight-hour workday. (R.

23.)
The ALJ considered Dr. Jankus’ consultative examination report from October 2020
and recounted Dr. Jankus’ findings regarding strength, gait, sensation, trace or slight
clumsiness in the left hand, and no severe fine motor issues. (R. 21.) The ALJ also noted
that Dr. Jankus agreed with Plaintiff’s assessment of 80% functionality on the left-side

upper and lower extremities as “pretty realistic,” but pointed out that Dr. Jankus “did not
opine any specific left upper and/or lower extremity limitations.” (R. 21.)
The ALJ also considered the persuasiveness of Dr. Hammes’ medical source
statement from January 2021. The ALJ’s entire discussion follows:
The undersigned finds this opinion to be unpersuasive in assessing specific
work limitations since October 7, 2019, because the opined limits are not
supported by and are not consistent with the objective examination findings,
the treatment notes and observations from this and other providers, course of
treatment, consultative examination, and overall functioning for any 12-
month duration discussed in detail above. The records do not support this
degree of limitation persisted or is expected to persist 12 months in duration.
It is significant to note that this January 18, 2021 form was completed less
than one month after her December 2020 stroke.
(R. 24.)
Based on the ALJ’s consideration of all the evidence of record, the ALJ assessed
Plaintiff’s RFC as follows.
[Plaintiff] has the residual functional capacity to perform light work as
defined in 20 CFR 404.1567(b) and 416.967(b) with lifting and/or carrying
20 pounds occasionally and 10 pounds frequently, standing and/or walking
with normal breaks for a total of 4 hours out of an 8-hour workday, sitting
with normal breaks for a total of 6 hours in an 8-hour workday, occasional
climbing of ladders, ropes, or scaffolds, no balancing in the context of being
at unprotected heights, and overall, no work at unprotected heights or with
hazardous or dangerous moving machinery, in addition to simple routine,
repetitive types of tasks and instructions that would be fixed and predictable
from day to day with few, if any, workplace changes in the nature of the tasks
to be performed, occasional brief and superficial contact with coworkers and
the public, however, the tasks can be performed independently and would
not require collaboration or teamwork and would not involve direct serving
of the public to be completed, and with respect to interaction with
supervisors, that would be consistent with the Dictionary of Occupational
Titles’ people code designation of no less than an 8 as defined in the
Dictionary of Occupational Titles and its companion, and finally, no fast pace
high production goal or quota types tasks such as on an assembly line,
moving conveyor belt, or requiring constant handling, fingering or reaching
as defined in the Dictionary of Occupational Titles.

(R. 19.) With this RFC, the ALJ concluded, Plaintiff could not perform her past work as a
home attendant, but she could work as a small products assembler, inspector and hand
packager, and garment sorter. (R. 26.) Consequently, Plaintiff was not disabled. (R. 27.)
The Appeals Council denied Plaintiff’s request for review of the ALJ’s decision.
(R. 1.) This made the ALJ’s decision the final decision of the Commissioner for the purpose
of judicial review.
II. Standard of Review
Judicial review of the Commissioner’s denial of benefits is limited to determining

whether substantial evidence in the record as a whole supports the decision,

42 U.S.C. § 405

(g), or whether the ALJ committed an error of law, Nash v. Commissioner, Social 
Security Administration,

907 F.3d 1086, 1089

 (8th Cir. 2018). “Substantial evidence is less 
than a preponderance but is enough that a reasonable mind would find it adequate to 
support the Commissioner’s conclusion.” Krogmeier v. Barnhart,

294 F.3d 1019, 1022

 
(8th Cir. 2002) (citing Prosch v. Apfel,

201 F.3d 1010, 1012

 (8th Cir. 2000)). The Court 

must  examine  “evidence  that  detracts  from  the  Commissioner’s  decision  as  well  as 
evidence that supports it.”

Id.

 (citing Craig v. Apfel,

212 F.3d 433, 436

 (8th Cir. 2000)). 
The Court may not reverse the ALJ’s decision simply because substantial evidence would 
support a different outcome or because the Court would have decided the case differently.

Id.

 (citing Woolf v. Shalala,

3 F.3d 1210, 1213

 (8th Cir. 1993)). In other words, if it is 

possible to reach two inconsistent positions from the evidence and one of those positions 
is that of the Commissioner, the Court must affirm the decision. Robinson v. Sullivan,

956 F.2d 836, 838

 (8th Cir. 1992).                                            
   A claimant has the burden to prove disability. See Roth v. Shalala,

45 F.3d 279, 282

 
(8th Cir. 1995). To meet the definition of disability for DIB and SSI, the claimant must 

establish that she is unable “to engage in any substantial gainful activity by reason of any 
medically determinable physical or mental impairment which can be expected to result in 
death or which has lasted or can be expected to last for a continuous period of not less than 
12 months.”

42 U.S.C. § 423

(d)(1)(A); 42 U.S.C. § 1382c(a)(3)(A). The disability, not just 
the impairment, must have lasted or be expected to last for at least twelve months. Titus v. 
Sullivan,

4 F.3d 590, 594

(8th Cir. 1993).

III. Discussion
A. The ALJ Erred in Determining that Plaintiff Had No Left-Hand
Limitations.

Plaintiff argues that the ALJ failed to fully account in the RFC assessment for the
limitations caused by Plaintiff’s moyamoya disease and resultant strokes. The Court agrees.
The ALJ’s decision not to include any left-hand limitations in the RFC is not supported by
substantial evidence of record. Although the degree of limitation that existed immediately
after Plaintiff’s December 2020 stroke might not have met the 12-month durational
requirement, the record does not support a finding that there were no left-hand limitations
that would meet the 12-month durational requirement.
The first reason why the record does not support a finding that there were no left-
hand limitations that would meet the 12-month durational requirement after the December
2020 stroke is Plaintiff’s history of long-term, left-hand limitations after her November
2018 stroke. In October 2020, almost two years after the November 2018 stroke, but before

the December 2020 stroke, Plaintiff told Dr. Jankus that her left leg felt heavy and her left
hand was slower than her right hand. Plaintiff estimated that her left hand, arm, foot, and
leg had about 80% of the strength and functioning of her right hand, arm, foot, and leg, and
Dr. Jankus agreed. In November 2020—two years after the November 2018 stroke, but still
before the December 2020 stroke—Plaintiff reported numbness and tingling in her left

hand and left-side weakness to Dr. Hammes, and the doctor’s physical examination
confirmed that Plaintiff’s left-hand grip was weaker than her right-hand grip and that
Plaintiff had numbness and tingling in her left hand. It would be illogical to conclude that

Plaintiff would not continue to have at least these limitations after her December 2020
stroke.
To support Defendant’s argument that substantial evidence supported the ALJ’s
finding that Plaintiff’s stroke did not have residual effects for 12 months or more,
Defendant relies on a treatment record from speech pathologist Jenna Kuntz, who
commented that Plaintiff “was at or near baseline level of function.” (Def.’s Mem. at 5

(citing R. 800), Dkt. No. 16.) Defendant argues, “Baseline functioning is normal
functioning.” (Id.) The Court does not disagree with Defendant on the meaning of “baseline
functioning,” but Defendant has taken Ms. Kuntz’s comment out of context. Ms. Kuntz
was simply summarizing her review of Plaintiff’s chart as part of an initial assessment for
speech therapy services. (R. 800.) Ms. Kuntz did not make any independent findings of

Plaintiff’s left-side functioning. Moreover, Ms. Kuntz’s comment about baseline
functioning related specifically to a visit that a speech-language pathologist (“SLP”) made
to Plaintiff in the hospital: “She was also seen by SLP during most recent [hospitalization]
and it was determined that patient was at or near baseline level of function.” (R. 800.) This
hearsay that is limited to speech-language pathology is not substantial evidence of

Plaintiff’s left-side functioning.
The second reason why the record does not support the ALJ’s finding that there
were no left-hand limitations that would meet the 12-month durational requirement after
the December 2020 stroke is that the ALJ either mischaracterized Plaintiff’s testimony or
failed to resolve inconsistencies in her testimony. Plaintiff did not testify “to no left hand
limitation prior to her stroke in December 2020” (see R. 16), which is the reason the ALJ

gave for not including left-hand limitations in the RFC.
Confusion over the date of the “second stroke” and when Plaintiff experienced left-
hand limitations arose at the hearing when the interpreter attempted to clarify Plaintiff’s
testimony by asking her about the “last – the second stroke” after Plaintiff testified that her
left-hand limitations dated back to November 2019. Plaintiff’s representative increased
confusion over dates by mistakenly stating that Plaintiff had a stroke just before she

stopped working in October 2019. (R. 44 (Q: “[Y]ou stopped working as a PCA in October
of 2019? A: Yes. Q: Okay, because that’s when you had a stroke.”) Rather than describing
the four known strokes by date, however, the interpreter, Plaintiff’s representative, and
Plaintiff all referred to the “second stroke” instead of referring to the stroke by date. The
dates of the strokes matter. Indeed, the second known stroke occurred in 2017, and if

Plaintiff was referring to that stroke when she testified about when her left-hand limitations
began, her testimony would establish that the limitations met the 12-month durational
requirement, contrary to the ALJ’s finding that Plaintiff “testified to no left hand limitation
prior to her stroke in December 2020.”
Furthermore, Plaintiff’s third stroke occurred in November 2018—not November

2019, which is when Plaintiff testified her left-hand limitations began—but the dates are
similar enough that Plaintiff might have intended to testify (or did testify, and the
interpreter mis-clarified the year) that her left-hand limitations dated back to November
2018. If so, that testimony would also be at odds with the ALJ’s finding that Plaintiff did
not testify to limitations preceding the December 2020 stroke. The testimony would also
correspond with findings from Dr. Hammes in November 2020 that Plaintiff had

numbness, tingling, and weakness in her left hand, and from Dr. Jankus in October 2020
that Plaintiff had only 80% functionality in her left arm and hand. Several treatment notes
document Plaintiff’s confusion and difficulties with an interpreter at her medical
appointments.
When it was the ALJ’s turn to question Plaintiff, the ALJ did refer to the “most
recent stroke . . . towards the end of 2020.” (R. 43.) But the ALJ did not ask Plaintiff

specifically about left-hand limitations following that stroke. Rather, the ALJ asked
Plaintiff how she spent her days before the December 2020 stroke. Plaintiff answered that
she mostly sat around, but did some minor dishwashing, swept the floor, shopped for
groceries, and ran errands. Those activities are not necessarily incompatible with some
degree of left-hand limitation, and it was not an accurate characterization of Plaintiff’s

testimony to say that she testified to no left-hand limitations before the December 2020
stroke.
In light of evidence that Plaintiff had left-hand limitations after her November 2018
stroke, the confusion at the hearing about which stroke happened when, and Plaintiff’s
actual testimony about her left-hand limitations and daily activities, the ALJ’s decision not

to include any left-hand limitations in the RFC is not supported by substantial evidence of
record. The error is not harmless because all of the jobs identified by the ALJ at step five
require frequent reaching and handling, and at least occasional fingering. (R. 26, 48);
Dictionary of Occupational Titles 706.684-022 (Assembler, Small Products I), 559.687-
074 (Inspector and Hand Packager), 222.687-014 (Garment Sorter). Although the RFC
assessed by the ALJ precluded constant handling, fingering, or reaching, this limitation

applied to right hand as well as the left, and thus, no particular consideration was given to
specific left-hand limitations. The Court will remand the matter for the ALJ to consider
whether any left-hand limitations satisfied the 12-month durational requirement, with
particular consideration given to Plaintiff’s testimony and the corresponding medical
evidence of record. The ALJ may also choose to take additional testimony from Plaintiff.
Plaintiff suggests that the ALJ should have retained a medical expert or ordered

another consultative examination to explain how the December 2020 stroke and resulting,
long-term limitations affected her RFC. The Court will not require the ALJ to take either
action on remand, but the ALJ may certainly choose to retain a medical expert or order a
new consultative examination in resolving any insufficiencies or inconsistencies in the
record. See

20 C.F.R. §§ 404

.1520b(b); 416.920b(b).                       

   B.   The ALJ Erred in Considering Dr. Hammes’ Opinion.               
   Plaintiff  argues  that  the  ALJ  erred  in  considering  the  persuasiveness  of  Dr. 
Hammes’  medical  opinion  dated  January  18,  2021.  The  ALJ  found  the  opinion 
unpersuasive primarily because the ALJ found the opinion did not support a finding that 
the degree of limitation Plaintiff had one month after her December 2020 stroke would 

persist for at least 12 months.                                           
   Title

20 C.F.R. §§ 404

.1520c and 416.920c set forth the standards under which an 
ALJ considers medical opinion evidence. An ALJ considers how “persuasive” an opinion 
is according to five factors: supportability, consistency, relationship with the claimant, 
specialization,  and  any  other  relevant  factors.

20 C.F.R. §§ 404

.1520c(c)(1)–(5), 
416.920c(c)(1)–(5). The “most important factors” are supportability and consistency.

20 C.F.R. §§ 404

.1520c(b)(2), 416.920c(b)(2). The ALJ “may, but [is] not required to,” 
explain  how  the  remaining  factors  were  considered.

20 C.F.R. §§ 404

.1520c(b)(2), 
416.920c(b)(2).                                                           
   The regulatory language pertaining to supportability provides that “[t]he more 
relevant  the  objective  medical  evidence  and  supporting  explanations  presented  by  a 
medical source are to support his or her medical opinion(s) or prior administrative medical 

finding(s),  the  more  persuasive  the medical  opinions  or  prior  administrative medical 
finding(s)  will  be.”

20 C.F.R. §§ 404

.1520c(c)(1),  416.920c(c)(1).  In  evaluating 
consistency, “[t]he more consistent a medical opinion(s) or prior administrative medical 
finding(s) is with the evidence from other medical sources and nonmedical sources in the 
claim, the more persuasive the medical opinions or prior administrative medical finding(s) 

will be.”

20 C.F.R. §§ 404

.1520c(c)(2), 416.920c(c)(2). In other words, supportability 
looks to how well the medical source justifies their own opinion, and consistency looks to 
how well the medical source’s opinion fits with evidence from other sources.  
   Given that the supportability and consistency factors are the most important factors 
to the persuasiveness determination, an ALJ “will explain how [the ALJ] considered the 

supportability and consistency factors for a medical source’s medical opinions . . . .”

20 C.F.R. §§ 404

.1520c(b)(2), 416.920c(b)(2). “The ALJ need not use the magic words of 
‘supportability’ and ‘consistency,’ but it must be clear they were addressed.” Svendsen v. 
Kijakazi, No. 1:21-CV-1029-CBK,

2022 WL 2753163

, at *8 (D.S.D. July 14, 2022). The 
ALJ’s failure to articulate how he or she considered these factors is a legal error that 
warrants remand. Susan H. v. Kijakazi, No. 21-CV-2688 (ECT/ECW),

2023 WL 2142786

, 

at *3 (D. Minn. Feb. 21, 2023); Michael B. v. Kijakazi, No. 21-CV-1043 (NEB/LIB),

2022 WL 4463901

, at *2 (D. Minn. Sept. 26, 2022); Joel M. B. v. Kijakazi, No. 21-CV-1660 
(PAM/ECW),

2022 WL 1785224

, at *3 (D. Minn. June 1, 2022) (citing Lucus v. Saul,

960 F.3d 1066, 1070

(8th Cir. 2020)).
With respect to supportability and consistency, the ALJ found Dr. Hammes’ opinion
unpersuasive in part because it was “not consistent with the objective examination findings,

the treatment notes and observations from this and other providers, course of treatment,
consultative examinations, and overall functioning.” (R. 24.) These general references to
the overall record do not satisfy the ALJ’s obligation to articulate how the ALJ considered
the supportability and consistency factors. The ALJ did not identify any inconsistent
evidence from other providers or undermining evidence from Dr. Hammes herself in her

discussion of Dr. Hammes’ opinion, nor did the ALJ explain in any detail how the
supportability and consistency factors were considered such that this Court could make a
meaningful assessment of the ALJ’s consideration of the opinion.
The only other bases the ALJ gave for finding Dr. Hammes’ opinion unpersuasive
were that Dr. Hammes completed the form only one month after Plaintiff’s December 2020

stroke and that the ALJ did not expect the limitations caused by the December 2020 stroke
to last for 12 months. The Court finds that to consider the residual effects of each of
Plaintiff’s strokes in isolation, however, is to disregard the chronic and progressive nature
of moyamoya disease. As a judge in the Northern District of Illinois said, when considering
an ALJ’s perfunctory summary of the medical evidence for a claimant with moyamoya
disease, “That’s it: stroke, surgery, discharge. It really doesn’t seem terribly bad at all,

when one puts it that way.” Michelle F. v. Kijakazi, No. 22 C 0183,

2022 WL 5183904

, at 
*5 (N.D. Ill. Oct. 5, 2022). Here, the ALJ’s summary of Plaintiff’s moyamoya disease 
might read: stroke, recovery, stroke, recovery, stroke, recovery, stroke, a bit more limited 
in recovery. The unpredictable nature, timing, and persistence of the strokes and resultant 
limitations—a characteristic of moyamoya disease—should not be the basis to find a 
medical opinion unpersuasive. Over and above that, the confusion over which stroke 

anybody in this case was referring to at any given time means that the ALJ erroneously 
concluded that Dr. Hammes’ opinion was premised only on Plaintiff’s December 2020 
stroke. It was not so limited, as detailed above.                         
   The  Commissioner  offers  several  post-hoc  rationalizations  for  the  ALJ’s 
consideration of the supportability and consistency factors and points to evidence from Dr. 

Hammes and others that the ALJ did not include in her consideration of these factors. The 
Court cannot accept these post-hoc arguments. See Stafford v. Kijakazi, No. 4:20-CV-1011-
NKL,

2022 WL 358061

, at *4 (W.D. Mo. Feb. 7, 2022); Shanda v. Colvin, No. 14-CV-
1838 (MJD/JSM),

2015 WL 4077511

, at *30 (D. Minn. July 6, 2015) (citing S.E.C. v. 
Chenery Corp.,

318 U.S. 80, 87

 (1943)) (limiting judicial review of an agency’s final 

decision to the bases given in the decision). “It is not the role of this Court to speculate on 
the reasons that might have supported the ALJ’s decision or supply a reasoned basis for 
that decision that the ALJ never gave.” Stacey S. v. Saul, No. 18-cv-3358 (ADM/TNL),

2020 WL 2441430

, at *15 (D. Minn. Jan. 30, 2020), R. & R. adopted,

2020 WL 1271163

(D. Minn. Mar. 17, 2020).

C. The ALJ’s Preclusion of Constant Handling, Fingering, or Reaching Is
Consistent with Dr. Jankus’ Finding that Plaintiff’s Left Arm and Hand
Functioned at About 80%

Plaintiff contends that the ALJ’s preclusion of constant handling, fingering, or
reaching is not consistent with Dr. Jankus’ finding that Plaintiff’s left arm and hand
functioned at about 80%.6 Defendant responds that Dr. Jankus noted mostly normal
functioning and did not offer any specific left-side limitations.
The Court finds that the ALJ’s handling, fingering, and reaching limitation is not at
odds with Dr. Jankus’ findings. Dr. Jankus made some objective findings from his
examination of Plaintiff, such as symmetric strength and reflexes, full strength, smooth
gait, a “trace” amount of clumsiness and weakness in her left hand, and no severe fine
motor issues. He also agreed with Plaintiff that she had about 80% functionality in her left
arm and hand. Plaintiff has not explained how these findings are incompatible with the
ability to constantly handle, finger, or reach. “Constantly” describes an activity or condition
that exists two-thirds or more of the time. E.g., Dictionary of Occupational Titles 222.687-
014 (Garment Sorter). Dr. Jankus’ objective findings are not inconsistent with an ability to
handle, finger, or reach two-thirds of the time. Notably, however, as the ALJ acknowledged

6 Plaintiff identifies other inconsistencies between Dr. Jankus’ report and the RFC, but
those are based on Plaintiff’s subjective reports to Dr. Jankus (e.g., number of falling
episodes, how long she could stand and walk in an eight-hour period), not his objective
observations or findings. The Court’s discussion is limited to Dr. Jankus’s objective
observations and findings.
in the written decision, Dr. Jankus did not identify any specific left upper or lower
extremity limitations, so it is not possible to know for certain whether Dr. Jankus would

agree that Plaintiff could constantly handle, finger, or reach with her left hand and arm.
IV. Conclusion
Based on the foregoing, and on all of the files, records, and proceedings herein, IT
IS HEREBY ORDERED THAT:
1. The relief requested in Plaintiff’s Brief (Dkt. No. 12) is GRANTED.
2. The Commissioner’s decision is reversed and the matter is remanded pursuant to

sentence four of

42 U.S.C. § 405

(g) for consideration of (a) whether any left-hand 
   limitations  satisfied  the  12-month  durational  requirement,  with  particular 
   consideration given to Plaintiff’s testimony and corresponding medical evidence of 
   record; and (b) consideration of Dr. Sarah Hammes’ medical opinion pursuant to

20 C.F.R. §§ 404

.1520c and 416.920c.                                    

3.  Defendant’s Motion for Summary Judgment (Dkt No. 15) is DENIED.     

LET JUDGMENT BE ENTERED ACCORDINGLY.                                      


Date: March 28, 2024            s/  John F. Docherty                    
                                JOHN F. DOCHERTY                        
                                United States Magistrate Judge

Trial Court Opinion

                UNITED STATES DISTRICT COURT                            
                   DISTRICT OF MINNESOTA                                


Mai V.,                              Case No. 22-CV-2086 (JFD)          

              Plaintiff,                                                

v.                                          ORDER                       

Martin J. O’Malley, Commissioner of                                     
the Social Security Administration,                                     

              Defendant.                                                


   Pursuant to

42 U.S.C. § 405

vision problems, and cognitive or sensory impairment.

Id.

findings in December 2019. (R. 603.) Dr. Hammes wrote that Plaintiff seemed confused at
the November 2018 appointment, and at the December 2019 appointment, Plaintiff did not

Q Okay. So, before that second stroke, were you having any
difficulties using your left hand?

A Yes. Before the second stroke, I still had the movement, too.
So, I’d been working really hard to -- regaining its function. But after the
second stroke, I just cannot be able to use it anymore.

INT: Counsel, you’re talking about the first stroke, or the second
stroke?

REP: The first one.

A No issue.

Q Okay. Then why did you stop working as a PCA?

A Well, because of my stroke. I cannot help myself. . . . That’s
why I stopped working.

Q Okay. Why couldn’t you help yourself after the first stroke?
What was it that was going on with you, that prevented you from helping
yourself?

A So, after going to the hospital, coming back, I was pretty much
paralyzed. I’m not able to help myself and such. That’s the reason.

Q That was after the first stroke?

A Yes.

Q And how long did that last?

A That’s not been improving. I really want it to get better, but
things just getting worse, and going downhill since then.

Q But did you make some improvement after your first – between
your first stroke and your second stroke?

A No change. It seems like it’s just getting bigger and bigger.

A Yes. That’s correct.

A The problems -- the biggest problem is after the second stroke.
That’s when I could not be able to do anything. I feel like I’m going to
fainted, if I move it about.

20 C.F.R. §§ 404.1520

 and 416.920. At each step, the ALJ considered whether 
Plaintiff was disabled based on the criteria of that step. If she was not, the ALJ proceeded 
to the next step. See

20 C.F.R. §§ 404.1520

(a)(4), 416.920(a)(4).

(R. 16.)
Before proceeding to step four, the ALJ assessed Plaintiff’s RFC, which is a
measure of “the most [she] can still do despite [her] limitations.”

20 C.F.R. §§ 404.1545

whether substantial evidence in the record as a whole supports the decision,

42 U.S.C. § 405

(g), or whether the ALJ committed an error of law, Nash v. Commissioner, Social 
Security Administration,

907 F.3d 1086, 1089

 (8th Cir. 2018). “Substantial evidence is less 
than a preponderance but is enough that a reasonable mind would find it adequate to 
support the Commissioner’s conclusion.” Krogmeier v. Barnhart,

294 F.3d 1019, 1022

 
(8th Cir. 2002) (citing Prosch v. Apfel,

201 F.3d 1010, 1012

 (8th Cir. 2000)). The Court 

must  examine  “evidence  that  detracts  from  the  Commissioner’s  decision  as  well  as 
evidence that supports it.”

Id.

 (citing Craig v. Apfel,

212 F.3d 433, 436

 (8th Cir. 2000)). 
The Court may not reverse the ALJ’s decision simply because substantial evidence would 
support a different outcome or because the Court would have decided the case differently.

Id.

 (citing Woolf v. Shalala,

3 F.3d 1210, 1213

 (8th Cir. 1993)). In other words, if it is 

possible to reach two inconsistent positions from the evidence and one of those positions 
is that of the Commissioner, the Court must affirm the decision. Robinson v. Sullivan,

956 F.2d 836, 838

 (8th Cir. 1992).                                            
   A claimant has the burden to prove disability. See Roth v. Shalala,

45 F.3d 279, 282

 
(8th Cir. 1995). To meet the definition of disability for DIB and SSI, the claimant must 

establish that she is unable “to engage in any substantial gainful activity by reason of any 
medically determinable physical or mental impairment which can be expected to result in 
death or which has lasted or can be expected to last for a continuous period of not less than 
12 months.”

42 U.S.C. § 423

(d)(1)(A); 42 U.S.C. § 1382c(a)(3)(A). The disability, not just 
the impairment, must have lasted or be expected to last for at least twelve months. Titus v. 
Sullivan,

4 F.3d 590, 594

(8th Cir. 1993).

III. Discussion
A. The ALJ Erred in Determining that Plaintiff Had No Left-Hand
Limitations.

20 C.F.R. §§ 404

.1520b(b); 416.920b(b).                       

   B.   The ALJ Erred in Considering Dr. Hammes’ Opinion.               
   Plaintiff  argues  that  the  ALJ  erred  in  considering  the  persuasiveness  of  Dr. 
Hammes’  medical  opinion  dated  January  18,  2021.  The  ALJ  found  the  opinion 
unpersuasive primarily because the ALJ found the opinion did not support a finding that 
the degree of limitation Plaintiff had one month after her December 2020 stroke would 

persist for at least 12 months.                                           
   Title

20 C.F.R. §§ 404

.1520c and 416.920c set forth the standards under which an 
ALJ considers medical opinion evidence. An ALJ considers how “persuasive” an opinion 
is according to five factors: supportability, consistency, relationship with the claimant, 
specialization,  and  any  other  relevant  factors.

20 C.F.R. §§ 404

.1520c(c)(1)–(5), 
416.920c(c)(1)–(5). The “most important factors” are supportability and consistency.

20 C.F.R. §§ 404

.1520c(b)(2), 416.920c(b)(2). The ALJ “may, but [is] not required to,” 
explain  how  the  remaining  factors  were  considered.

20 C.F.R. §§ 404

.1520c(b)(2), 
416.920c(b)(2).                                                           
   The regulatory language pertaining to supportability provides that “[t]he more 
relevant  the  objective  medical  evidence  and  supporting  explanations  presented  by  a 
medical source are to support his or her medical opinion(s) or prior administrative medical 

finding(s),  the  more  persuasive  the medical  opinions  or  prior  administrative medical 
finding(s)  will  be.”

20 C.F.R. §§ 404

.1520c(c)(1),  416.920c(c)(1).  In  evaluating 
consistency, “[t]he more consistent a medical opinion(s) or prior administrative medical 
finding(s) is with the evidence from other medical sources and nonmedical sources in the 
claim, the more persuasive the medical opinions or prior administrative medical finding(s) 

will be.”

20 C.F.R. §§ 404

.1520c(c)(2), 416.920c(c)(2). In other words, supportability 
looks to how well the medical source justifies their own opinion, and consistency looks to 
how well the medical source’s opinion fits with evidence from other sources.  
   Given that the supportability and consistency factors are the most important factors 
to the persuasiveness determination, an ALJ “will explain how [the ALJ] considered the 

supportability and consistency factors for a medical source’s medical opinions . . . .”

20 C.F.R. §§ 404

.1520c(b)(2), 416.920c(b)(2). “The ALJ need not use the magic words of 
‘supportability’ and ‘consistency,’ but it must be clear they were addressed.” Svendsen v. 
Kijakazi, No. 1:21-CV-1029-CBK,

2022 WL 2753163

, at *8 (D.S.D. July 14, 2022). The 
ALJ’s failure to articulate how he or she considered these factors is a legal error that 
warrants remand. Susan H. v. Kijakazi, No. 21-CV-2688 (ECT/ECW),

2023 WL 2142786

, 

at *3 (D. Minn. Feb. 21, 2023); Michael B. v. Kijakazi, No. 21-CV-1043 (NEB/LIB),

2022 WL 4463901

, at *2 (D. Minn. Sept. 26, 2022); Joel M. B. v. Kijakazi, No. 21-CV-1660 
(PAM/ECW),

2022 WL 1785224

, at *3 (D. Minn. June 1, 2022) (citing Lucus v. Saul,

960 F.3d 1066, 1070

(8th Cir. 2020)).
With respect to supportability and consistency, the ALJ found Dr. Hammes’ opinion
unpersuasive in part because it was “not consistent with the objective examination findings,

when one puts it that way.” Michelle F. v. Kijakazi, No. 22 C 0183,

2022 WL 5183904

, at 
*5 (N.D. Ill. Oct. 5, 2022). Here, the ALJ’s summary of Plaintiff’s moyamoya disease 
might read: stroke, recovery, stroke, recovery, stroke, recovery, stroke, a bit more limited 
in recovery. The unpredictable nature, timing, and persistence of the strokes and resultant 
limitations—a characteristic of moyamoya disease—should not be the basis to find a 
medical opinion unpersuasive. Over and above that, the confusion over which stroke 

anybody in this case was referring to at any given time means that the ALJ erroneously 
concluded that Dr. Hammes’ opinion was premised only on Plaintiff’s December 2020 
stroke. It was not so limited, as detailed above.                         
   The  Commissioner  offers  several  post-hoc  rationalizations  for  the  ALJ’s 
consideration of the supportability and consistency factors and points to evidence from Dr. 

Hammes and others that the ALJ did not include in her consideration of these factors. The 
Court cannot accept these post-hoc arguments. See Stafford v. Kijakazi, No. 4:20-CV-1011-
NKL,

2022 WL 358061

, at *4 (W.D. Mo. Feb. 7, 2022); Shanda v. Colvin, No. 14-CV-
1838 (MJD/JSM),

2015 WL 4077511

, at *30 (D. Minn. July 6, 2015) (citing S.E.C. v. 
Chenery Corp.,

318 U.S. 80, 87

 (1943)) (limiting judicial review of an agency’s final 

decision to the bases given in the decision). “It is not the role of this Court to speculate on 
the reasons that might have supported the ALJ’s decision or supply a reasoned basis for 
that decision that the ALJ never gave.” Stacey S. v. Saul, No. 18-cv-3358 (ADM/TNL),

2020 WL 2441430

, at *15 (D. Minn. Jan. 30, 2020), R. & R. adopted,

2020 WL 1271163

(D. Minn. Mar. 17, 2020).

C. The ALJ’s Preclusion of Constant Handling, Fingering, or Reaching Is
Consistent with Dr. Jankus’ Finding that Plaintiff’s Left Arm and Hand
Functioned at About 80%

sentence four of

42 U.S.C. § 405

(g) for consideration of (a) whether any left-hand 
   limitations  satisfied  the  12-month  durational  requirement,  with  particular 
   consideration given to Plaintiff’s testimony and corresponding medical evidence of 
   record; and (b) consideration of Dr. Sarah Hammes’ medical opinion pursuant to

20 C.F.R. §§ 404

.1520c and 416.920c.                                    

3.  Defendant’s Motion for Summary Judgment (Dkt No. 15) is DENIED.     

LET JUDGMENT BE ENTERED ACCORDINGLY.                                      


Date: March 28, 2024            s/  John F. Docherty                    
                                JOHN F. DOCHERTY                        
                                United States Magistrate Judge

Reference

Status: Unknown