| | | | | | | | April 2025 Welcome to this quarter’s edition of the Disability Law News. This month, we spotlight sweeping changes led by the Department of Government Efficiency (DOGE), which have begun to reshape SSA operations, staffing, and regulatory priorities. From proposals to reclassify thousands of SSA employees under revived “Schedule F” authority to DOGE's growing influence on benefit adjudication and enforcement policy, advocates are watching closely for impacts on claimants’ rights and service access. We also review emerging litigation challenging SSA's data practices, including allegations under the Privacy Act and Rehabilitation Act that, and barriers to access due to recent procedural changes, which all could significantly affect how SSA collects, shares, and secures sensitive beneficiary information, as well as, how individuals access the Agency. Finally, we provide an overview of recent and proposed regulatory changes, including fast-tracked repeals of long-standing SSA rules. Be sure to read to the end and get introduced to the ALJ among us, Connor O’Brien. She graciously answered questions about her path from the bench to advocacy and we are sure you’ll enjoy learning more about her. | | | |  | | | Like many other federal agencies, the Social Security Administration’s (SSA’s) programs and services have been the subject of dramatic and far-reaching cuts and other changes initiated by the Department of Government Efficiency (DOGE) over the past three months. The changes have been expansive and rapid; several have already been partially reversed. Advocates, lawmakers, and others such as former Social Security Commissioners Martin O’Malley and Michael Astrue, have been raising a number of serious concerns, with increasing urgency, about the impact of these developments on Social Security claimants and the public. The Trump Administration and DOGE are stating that its efforts are necessary to reduce “waste and fraud,” at times offering false claims that SSA is paying thousands of dead beneficiaries on accounts of people in their 100s, 200s and older, and stating that DOGE’s efforts had uncovered “shocking levels of incompetence and probable fraud in the Social Security program.” However, statistics regarding fraud do not support those statements. According to the SSA Office of the Inspector General, less than 1 percent of payments are improper overpayments. Of those that are Title II overpayments, only 3 percent were attributable to fraud or to noncitizens living outside the United States. A timeline of many of the developments at SSA was published by Marketwatch, which continues to update the story as of April 25, 2025. There has been extensive coverage by other press outlets. | | | Dudek Named New Acting Commissioner As reported in the January 2025 newsletter, Michelle King had been named Acting Commissioner of the agency by President’s Trump transition team on January 17, 2017, while a vote to confirm Trump’s nominee for Commissioner, Frank Bisignano, advanced through the Senate. According to several sources, King left abrubtly on Feburary 17, 2025 after a dispute with DOGE over its attempts to access sensitive records maintained by SSA’s data systems. Following her objections, the White House elevated Leland Dudek to replace her as Acting Commissioner and King left SSA, retiring after over 30 years with the agency. Until his appointment, Dudek was on administrative leave pending an investigation for circumventing protocols to covertly facilitate DOGE’s access to the agency. He had been working as a senior advisor in SSA’s Office of Program Integrity, and his elevation to Acting Commissioner was made despite his not being in the executive ranks of the agency. DOGE’s entry into SSA is the subject of a lawsuit filed in the District Court of Maryland and discussed in more detail later in this newsletter. Several lawmakers have called for Dudek’s resignation. But as had been originally expected with King, Dudek’s placement will presumably last until Bisignano is confirmed as Commissioner. | | | | | | | | | | On April 25, 2025, the Social Security Administration (SSA) issued Emergency Message (EM) 25029 implementing a default withholding rate of up to 50 percent of a person’s monthly benefit for Title II overpayments beginning as of that date. The action partially reverses a change that SSA had made less than two months prior, on March 7, 2025, when SSA had announced by press release that it would reinstate a default overpayment rate of 100 percent. Full recoupment for Title II overpayments was SSA’s policy until it was changed about a year ago by then-Commissioner Martin O’Malley. As reported in the April 2024 issue of this newsletter, SSA dropped the “heavy-handed practice” of recouping the entirety of a Social Security beneficiary’s monthly benefit and changed the default rate to ten percent of the monthly benefit or $10, whichever is greater. The changes followed a comprehensive review of overpayment policies launched in response to public outcry about the devastating consequences faced by claimants with huge overpayments. | | | O’Malley described overpayment-related hardships as “injustices” that “shock our shared sense of equity and good conscience as Americans,” and said that policies aimed at easing the burden of overpayments were “important steps to restore efficiency and humanity to this process.” SSA issued EM-24011 SEN on March 25, 2024 to implement that change. The EM had a retention date of October 25, 2024. When SSA announced in March that it was reverting to a default of 100 percent, it stated that it would apply the new rule to overpayments issued on or after March 27, 2025. Under the new EM, any new Title II overpayment notices issued beginning April 25, 2025 “will provide a default Title II overpayment benefit withholding rate of 50 percent. This default rate will apply if the individual does not request a lower rate of withholding, reconsideration, or waiver. EM-25029 states that the 10 percent rate will apply to all overpayment recovery actions “up through COM 07”. | | | | | | | | | | In a significant legal challenge, three major labor and retiree organizations—the American Federation of State, County and Municipal Employees (AFSCME), the American Federation of Teachers (AFT), and the Alliance for Retired Americans—filed suit against the Social Security Administration (SSA) and the U.S. Department of Government Efficiency (DOGE) in the U.S. District Court for the District of Maryland. The case, American Federation of State, County and Municipal Employees, AFL-CIO v. Social Security Administration, No. 1:25-cv-00596-ELH, alleges that the defendants unlawfully granted DOGE personnel access to sensitive SSA data systems, violating federal privacy laws and administrative procedures. Plaintiffs are represented by Democracy Forward. Thus far, and discussed more below, there has been a temporary restraining order and preliminary injunction in favor of the plaintiffs and the Fourth Circuit has also declined to stay the district court's injunction. The plaintiffs contend that DOGE operatives, under the direction of Elon Musk, who is described in the complaint as the “de facto head” of DOGE, were given unauthorized access to SSA's confidential records. These records include personally identifiable information such as Social Security numbers, medical histories, financial data, and employment records. | | | The complaint asserts that this access was granted without the consent of the individuals affected and without adherence to the requisite legal frameworks, including the Privacy Act of 1974 and the Administrative Procedure Act (APA). Central to the lawsuit is the claim that the SSA failed to issue a required System of Records Notice (SORN) before allowing DOGE personnel to access its data systems. Under the Privacy Act, federal agencies must publicly disclose any new or revised systems of records and the routine uses of such records. The plaintiffs argue that the SSA's actions circumvented this requirement, thereby denying affected individuals the opportunity to comment on or contest the changes. The plaintiffs are seeking injunctive relief to prevent further unauthorized access to SSA data by DOGE personnel, as well as the removal of any software installed by DOGE on SSA systems. They also request that any data already accessed or altered by DOGE be identified and that measures be taken to mitigate potential harm resulting from these alleged privacy breaches. | | | | | | | |  | | | In the case American Association of People with Disabilities et al. v. Dudek et al., No. 1:25-cv-00977 (D.D.C.), a coalition of disability rights organizations and individual plaintiffs filed a federal lawsuit against top officials at the Social Security Administration (SSA) and the Department of Government Efficiency (DOGE), alleging sweeping violations of statutory and constitutional law. The suit, brought by the American Association of People with Disabilities (AAPD), Massachusetts Senior Action Council, and others, accuses SSA leadership - under the influence of Elon Musk, described in the complaint as the “de facto head” of DOGE - of dismantling vital public benefit infrastructure and denying disabled and older Americans their rights to essential services. The complaint, filed in April 2025, focuses on recent administrative overhauls that plaintiffs claim have severely degraded the SSA’s ability to serve the public. Among the changes at issue are the closure of the Office of Civil Rights and Equal Opportunity (OCREO), elimination of the Office of Transformation, drastic cutbacks to SSA’s national telephone assistance lines, and an alleged consolidation of agency authority that has left local SSA offices overwhelmed and functionally inoperable. | | | Plaintiffs argue these actions constitute an “unprecedented and unconstitutional assault on Social Security benefits,” particularly affecting people with disabilities who depend on timely and accessible agency services to receive or maintain benefits. Central to the lawsuit are three major legal claims. First, the plaintiffs contend that the agency’s failure to provide accessible services constitutes a violation of Section 504 of the Rehabilitation Act of 1973, which requires federal agencies to ensure meaningful access for individuals with disabilities. Second, the lawsuit asserts that the SSA implemented major policy shifts without proper rulemaking or public input, violating the Administrative Procedure Act (APA). Finally, the plaintiffs claim that these abrupt and unannounced changes infringe upon beneficiaries’ due process rights under the Fifth Amendment, depriving them of protected property interests in Social Security and disability benefits without adequate procedural safeguards. | | | | | | | | | |  | Click here for downloadable pdf - 1, 2 | | | | | | | | Millions of individuals recently received letters related to the Campos Class Action. As reported in the January 2024 issue of Disability Law News, the Campos v. Kijakazi class action lawsuit was filed against the Social Security Administration (SSA), alleging that the SSA wrongfully reduced or denied Supplemental Security Income (SSI) benefits for certain individuals based on the improper counting of in-kind support and maintenance (ISM). A settlement was reached on November 30, 2023, and advocates and representatives are finally seeing it trickle down to the recipients this spring. A recent February 2025 Emergency Message (EM) (EM-24005 REV 2) offered detailed guidance about the settlement notice and how offices are to be handling the cases. In brief, under the Campos settlement, nearly a quarter million SSI recipients are to receive relief if they incurred overpayments during March 2020 to September 2020 that were manually processed. | | | These overpayments will be waived. If a class member has repaid all or part of the overpayment, they will have back benefits credited to their accounts without having to take any action. The settlement also provided relief to another group of nearly two million more recipients by clarifying the standards by which they can request waivers of overpayments that arose during the COVID-19 National Emergency Period of March 2020 to April 2023. The notice typically outlines a recipient’s rights and explains how they will be contacted for further action. While some overpayments will be waived automatically, others will have to rely on the individualized notices for the process to request an overpayment waiver. | | | | | | | |  | | | Recently it was reported that Office of Management and Budget (OMB) gave the Social Security Administration (SSA) its proposed budget (fiscal year starting 10/1), which cut funding for the Social Security Advisory Board (SSAB) from $3 million to zero. Clearly, defunding the Board will bring its work to a halt, but officially ending the Board will require an act of Congress. Created by Congress in 1994 as part of the Social Security Independence and Program Improvements Act, the SSAB was designed to provide independent, bipartisan advice on Social Security policy and administration. SSBA has operated as an oversight and research body, offering reports, recommendations, and analyses intended to ensure the long-term solvency and effectiveness of Social Security. | | | The Board was unique in that it had no direct authority over SSA but played a critical role in influencing policy and providing a forum for stakeholder input and public dialogue. Some lawmakers are already proposing legislation to reinstate funding or reconstitute the Board under a different structure, though prospects remain uncertain amid a divided Congress. The concern for advocates is that the defunding, and ultimate dismantling, of oversight mechanisms could deepen the risk of mismanagement or political misuse of Social Security funds. We will keep readers apprised of updates with the SSAB. | | | | | | | | In our last newsletter we detailed the changes that the Social Security Fairness Act of 2023. This legislation was aimed at enhancing retirement benefits for public sector employees, including teachers, firefighters, and police officers, by eliminating the government pension offset. The implementation of this significant change has not been smooth, with the burden on the affected individuals to ensure proper payment. The changes were effective January 2025, but the roll-out faced challenges due to a continuing resolution and changes in the Social Security Administration (SSA) with technology and staffing. | | | In February 2025, Lee Dudek, Acting Commissioner of Social Security, announced that the original estimate of implementation taking a year or more will only apply to complex cases, and most recipients should see the retroactive payment in March and ongoing monthly change beginning in April due to automated processing. As of March 4, the SSA had paid out more than $7.5 billion in retroactive payments to more than 1.1 million people, with an average retroactive payment of $6,710. However, due to shortcomings with the automation efforts, it is estimated that there are an estimated 500,000 to 700,000 cases still to be processed. | | | | | | Rules & Regulations _______________________________________________________________________________________________________ | |  | | | | | In a significant move to reshape federal regulatory practices, President Donald J. Trump issued Executive Order 14219 on February 19, 2025, titled “Ensuring Lawful Governance and Implementing the President’s ‘Department of Government Efficiency’ Deregulatory Initiative.” This order mandates a comprehensive review of existing regulations to identify and repeal those deemed unlawful or exceeding statutory authority. Subsequently, on April 9, 2025, the administration released a memorandum directing agencies to expedite the repeal process for such regulations. EO 14219 required all executive departments and agencies to conduct a 60-day review of their regulations to identify rules that exceed statutory authority, conflict with constitutional principles; or which are potentially unlawful under recent Supreme Court decisions, including West Virginia v. EPA, Seila Law v. CFPB, and NFIB v. OSHA. Alarmingly broad, it targeted “regulations based on anything other than the best reading of the underlying statutory authority or prohibition”. | | | Following the initial review period, the April 9 memorandum instructed agencies to: Just prior to the deadline for responsive agency submissions to the White House, on April 11, 2025, OMB also published a notice styled as “Request for Information: Deregulation,” which seeks comments from the broader public on “regulations that are unnecessary, unlawful, unduly burdensome, or unsound.” This brief public Request for Information (RFI) from OMB asks commentators specifically to identify “regulations that stifle American businesses and American ingenuity.” | | | | | | | | | | The U.S. Office of Personnel Management (OPM) has issued a proposed rule (Docket ID: OPM-2025-0004, RIN 3206-AO80) aimed at increasing accountability within the federal civil service by modifying the employment status and procedural protections of certain policy-influencing positions. The proposal, titled Improving Performance, Accountability and Responsiveness in the Civil Service, was published in the Federal Register on April 23, 2025. The proposed rule introduces a new category within the excepted service called "Schedule Policy/Career." This is essentially a rebranding of "the prior Trump Administration's proposed "Schedule F," an excepted service category that makes it easier to hire and fire policy-influencing federal workers without due process protections. | | | Positions classified under this schedule are intended to be policy-influencing roles that remain career appointments filled on a nonpartisan basis. However, employees in these positions would serve at-will and would not be covered by the procedural protections outlined in chapters 43 and 75 of title 5 of the U.S. Code, which govern performance-based actions and adverse actions, respectively. Under the proposed rule, employees whose positions are reclassified into Schedule Policy/Career would lose the procedural protections that typically accompany career civil service positions. This change aims to enhance the ability of agency supervisors to address issues of poor performance or misconduct more efficiently. However, it also raises concerns about the potential erosion of civil service protections and the risk of politicizing career positions. | | | | | | | | Studies & Reports _______________________________________________________________________________________________________ | | | | NASI Task Force Issues Report on AI at SSA On April 17, 2025, the National Academy of Social Insurance’s Task Force on Artificial Intelligence (AI), Emerging Technology, and Disability Benefits released its Phase One report on current and future use of AI in, and related technology at, the Social Security Administration (SSA). The report covers how SSA is currently using AI in the disability determination process, the risks involved in using AI in the context of disability benefits, as well as the potential opportunities for program administration that AI may provide. The report has been anticipated by advocates as timely. AI is already in use at SSA. For example, SSA recently announced it would complete the rollout of its Hearing Recording and Transcriptions (HeaRT) system in March. The HeaRT system replaces a recording hardware system with a software-only solution that records and produces transcripts for each hearing. SSA claims HeaRT improves efficiencies by providing more accurate automated transcripts through generative AI, leading to fewer hearing delays. | | | New AI tools are being developed and introduced by the Department of Government Efficiency (DOGE) and the Acting Commissioner of Social Security Leland Dudek. Notably, nominee for Commissioner Frank Bisignano has been described as being someone who will apply his finance technology background to aggressively streamline SSA’s processes through AI and other technology. As noted earlier in this newsletter, his testimony at his confirmation hearing highlighted some potential uses of AI. Recent reporting about the use of AI in disability benefits programs in other parts of the world, however, have warned about algorithms “misfiring” to wrongfully deny complex cases. The NASI report urges safeguards to protect against similar risks, including measures to ensure meaningful human review, measures to prevent bias, and adequate governance and oversight. | | | | | | | | | | | | Send Us Your Decisions! Have you had a recent ALJ or court decision or SSA update that you would like to see reported in an upcoming issue of the Disability Law News? We would love to hear from you! Contact Katherine Courtney, [email protected] or Emilia Sicilia, [email protected] | | | | | | | | | _______________________________________________________________________________________________________ | | This "Bulletin Board" contains information about recent disability decisions from the United States Supreme Court and the United States Court of Appeals for the Second Circuit. The Second Circuit summaries, as well as earlier decisions, are also available here. Synopses of non-precedential summary orders issued by the Second Circuit are available here. We will continue to write more detailed articles about significant decisions as they are issued by these and other Courts, but we hope that these lists will help advocates gain an overview of the body of recent judicial decisions that are important in our judicial circuit. | | | | U.S. v. Vaello Madero, 142 S. Ct. 1539 (April 22, 2022) In an 8-1 decision, the Supreme Court held that the exclusion of residents of Puerto Rico from the Supplemental Security Income (SSI) program does not violate the United States Constitution. The Court applied the rational basis test to find it permissible to treat residents of territories such as Puerto Rico differently than if they lived in a state because of the different tax status applicable to territories, an outcome authorized by the Territories Clause of the Constitution. The Court declined to rebuke the Insular Cases, a line of case law that sanctioned the colonial relationship of the U.S. to the territories, and that determined the full scope of the Constitution did not apply. A lone dissent by Justice Sonia Sotomayor described the majority decision as “especially cruel given those citizens’ dire need for aid.” Carr v. Saul, 141 S.Ct. 1352 (Apr. 22, 2021) The Supreme Court held that a claimant is not precluded from raising a legal issue for the first time in U.S. District Court if it was not raised before the Administrative Law Judge (ALJ). The underlying issue in question in Carr and its companion cases was whether the ALJ was properly appointed under the Appointments Clause of the U.S. Constitution. In the aftermath of Lucia v. Securities and Exchange Commission, 138 S.Ct. 2044 (2018) challenging the constitutionality of SEC ALJs, Carr and other plaintiffs challenged the legitimacy of the ALJs who had denied their disability claims and sought new hearings. The Commissioner argued the plaintiffs had forfeited their Appointments Clause challenges because they had not raised them before SSA during the administrative appeals process. The Supreme Court resolved a conflict in the circuits by holding that given the non-adversarial nature of SSA hearings, issue-exhaustion is not required. Smith v. Berryhill, 139 S.Ct. 1765 (2019) The Supreme Court held that an Appeals Council dismissal of a request for review is a final decision subject to judicial review. The Court unanimously held that where the Appeals Council has dismissed a request for review as untimely after a claimant has obtained a hearing from an ALJ on the merits, the dismissal qualifies as a “final decision . . . made after a hearing” within the meaning of 42 U.S.C § 405(g). It distinguished its earlier ruling in Califano v. Sanders, 430 U.S. 99, 97 S.Ct. 980, 51 L.Ed.2d 192 (1977), by emphasizing that as opposed to the denial of a request for reopening in Sanders, there had been a decision by an ALJ on the merits of the plaintiff’s claim. Biestek v. Berryhill, 139 S.Ct. 1148 (2019) In a 6-3 decision, the Court declined to adopt a categorical rule that a vocational expert’s supporting data must be provided in order for the testimony to constitute substantial evidence. But the majority acknowledged that in some cases it may be possible to draw an adverse inference against a VE who refuses to provide supporting data. | | | | Rubin v. Martin O’Malley, 116 F.4th 145 (2d. Cir. 2024) The Court of Appeals remanded for consideration of the C criteria of Mental Impairment Listing 12.04, finding that the ALJ had failed to provide any rational for why the plaintiff did not meet the criteria. The court also offered what could be helpful language on the limited value of Mental Status Exams (MSEs) that can often derail claims. And it acknowledged that a psychiatrist’s opinion can be based on and supported by the totality of the medical evidence from the whole treatment team, not merely his own limited notes. It rejected, however, the plaintiff’s argument that the ALJ erred in denying the claim without the support of a medical opinion that she could work. But because the ALJ had found the psychiatrist’s opinion and those of the non-examining consultants only partially persuasive and because the claimant had failed to attend a consultative examination, the ALJ’s decision was not supported by substantial evidence. The court remanded for a consultative examination and fuller consideration of the evidence of record. Rucker v. Kijakazi, 48 F.4th 86, 2022 WL 4074410 (2d Cir. Sept. 6, 2022) The court remanded under the pre 2017 opinion evidence regulations that applied to this case, finding the ALJ had not identified substantial evidence to support her conclusion that the plaintiff could work alone except for normal supervision. She also failed to provide good reasons for rejecting the limitations identified by the treating psychiatrist, erroneously rejecting it because it was based on the plaintiff’s own reports. Nor was the plaintiff’s periodic lack of complaints of symptoms sufficient given her lack of insight. The ALJ should not have relied on the plaintiff’s ability to attend therapy as an indication of ability to work. Nor did some positive progress notes and mental status exams justify rejecting the treating source. The ALJ also relied too heavily on a consultative exam. Schillo v. Kijakazi, 31 F.4th 64 (2d Cir. Apr. 6, 2022) The court affirmed the District Court decision under the pre 2017 opinion evidence regulations that applied in this case. It found the ALJ properly accorded lesser weight to the opinions of two treating physicians because one was conclusory and vague and the other, rendered in check-box format, was not supported by the medical evidence. And according to the court, both opinions as to the plaintiff’s tremors and sensory deficits were inconsistent with the medical evidence, which identified only mild tremors, and the plaintiff’s testimony. The court also agreed with the ALJ’s assessment that the opinion of the consultative examiner was entitled to even less weight. It rejected plaintiff’s argument that the ALJ could not make an RFC finding because she had declined to accord controlling weight to any of the medical opinions; the ALJ is entitled to weigh all available evidence to make RFC findings and her conclusion need not perfectly correspond with opinions of record. Finally, the court found that the ALJ’s failure to articulate the so-called Burgess factors for evaluating treating source opinions to be harmless error as it was evident she had applied the substance of the treating physician rule. Fields v. Kijakazi, 24 F.4th 845 (2d Cir. Jan. 28, 2022) The Court of Appeals held that the District Court erred in reducing attorney fees requested by plaintiff’s attorney, Binder & Binder, under 42 U.S.C. § 406(b), as a windfall. The Second Circuit, relying on its decision in Wells v. Sullivan (“Wells II”), 907 F.2d 367, 372 (2d Cir. 1990), and the Supreme Court in Gisbreath v. Barnhart, 535 U.S. 789, 808 (2002), held that to reduce a contingency fee solely on the grounds that the amount requested is a windfall, the court must be clear the fee was not earned by counsel. Here, the appeals court found that the plaintiff’s very experienced attorney represented him professionally, efficiently, and ultimately successfully in four ALJ hearings, several Appeals Council petitions, and two district court appeals. His request for a fee of $40,170, which was 25% of the plaintiff’s retroactive award, was not a windfall even though it constituted an hourly rate of $1,556.98 based on the 25.8 hours expended on representation in the federal court phases of the claims. Colgan v. Kijakazi, 22 F.4th 353 (2d Cir. Jan. 3, 2022) The court remanded, finding the ALJ erred in failing to accord controlling weight to the opinion of the treating physician under the pre 2017 opinion evidence regulations that applied in this case. The court held the ALJ failed to find good reasons under the old regulations for discounting the opinion of a concussion specialist that the plaintiff would be off task 33% of the day and absent more than four days per month due to her headaches and other impairments. The ALJ also erred in discounting the opinion because it was presented in “check box” form; the opinion was supported by voluminous treatment notes. The court criticized the ALJ for “cherry-picking” particular instances of improvement to create inconsistencies with the treating source opinion. And it criticized the ALJ for relying too heavily on the opinions of consulting physicians, particularly where the consulting opinions did not address or dispute the crux of the treating source’s opinion. Alexander v. Saul, 5 F.4th 139 (2d Cir. July 8, 2021), cert. denied, 142 S.Ct. 1461 (Apr. 4, 2022) The Second Circuit upheld a district court’s refusal to extend the time to appeal its decision affirming the Commissioner’s denial of an SSI claim. Although the Circuit was “sympathetic” to the plaintiff, it concluded the district court had not abused its discretion – even though the plaintiff filed her appeal and request for an extension only two days after the 60-day deadline expired. The district court had reasonably applied the “excusable neglect” factors rather “good cause” standard under Fed. R. App. P. 4(a)(5) because the plaintiff’s failure to appeal was at least partially due to her own inadvertence in failing to notify her attorney of her change of address rather than due to her alleged mental illness. The court refused to toll the Rule 4(a)(5) deadline as it is considered jurisdictional and less flexible than the statute of limitations governing the 60-day limit to seek judicial review under 42 U.S.C. § 405(g). Sczepanski v. Saul, 946 F.3d 152 (2d Cir. Jan. 7, 2020) The court held that ability to complete work during the probationary period is relevant to a disability claim. It remanded for further proceedings at Step five of the Sequential Evaluation to determine whether the claimant could perform work as required during the probationary period, including meeting the levels for absenteeism tolerated by the employer. Estrella v. Berryhill, 925 F.3d 90 (2d Cir. 2019) The Second Circuit remanded, finding the ALJ committed procedural error in failing to “explicitly” apply the factors laid out in Burgess v. Astrue, 537 F.3d 117 (2d Cir. 2008), for evaluating treating source opinions. The court reiterated its mandate, rooted both in regulation and precedent, for ALJs to follow specific procedures and adequately explain their reasoning when assigning weight to opinions, citing Selian v. Astrue, 708 F.3d 409, 419-20 (2d Cir. 2013), Halloran v. Barnhart, 362 F.3d 28, 32-33 (2d Cir. 2004)(per curiam). It found the ALJ “cherry picked” the evidence, particularly mental status exam results, without attempting to reconcile longitudinal inconsistencies in this mental health claim. And it criticized the ALJ for relying too heavily on the opinion of the consultative examiner, citing Selian. Lockwood v. Comm’r of SSA, 914 F.3d 87 (2d Cir. 2019) The Court of Appeals remanded because the ALJ had not met his affirmative obligation under SSR 00-4p to inquire about any possible or apparent conflicts between vocational testimony and the Dictionary of Occupational Titles (DOT). The court found the ALJ did not met his burden simply by asking the vocational expert if her testimony was consistent, especially where the ALJ found the plaintiff could not reach overhead, but the three jobs to which the VE testified all required frequent or occasional reaching. Lesterhuis v. Colvin, 805 F.3d 83 (2d Cir. 2015) The Court of Appeals remanded for consideration of a retrospective medical opinion from a treating physician submitted to the Appeals Council, citing Perez v. Chater, 77 F.3d 41, 54 (2d Cir. 1996). The ALJ’s decision was not supported by substantial evidence in light of the new and material medical opinion from the treating physician that the plaintiff would likely miss four days of work per month. Since the vocational expert had testified a claimant who would be absent that frequently would be unable to work, the physician’s opinion, if credited, would suffice to support a determination of disability. The court also faulted the district court for identifying gaps in the treating physician’s knowledge of the plaintiff’s condition. Citing Burgess v. Astrue, 537 F.3d 117, 128 (2d Cir. 2008), the court reiterated it may not “affirm an administrative action on grounds different from those considered by the agency.” Greek v. Colvin, 802 F.3d 370 (2d Cir 2015) The court remanded for clarification of the treating source’s opinion, particularly as to the claimant’s ability to perform postural activities. The doctor had also opined that Mr. Greek would likely be absent from work more than four days a month as a result of his impairments. Since a vocational expert testified there were no jobs Mr. Greek could perform if he had to miss four or more days of work a month, the court found the ALJ’s error misapplication of the factors in the treating physician regulations was not harmless. "After all, SSA's regulations provide a very specific process for evaluating a treating physician's opinion and instruct ALJs to give such opinions 'controlling weight' in all but a limited range of circumstances. See 20 C.F.R. § 404.1527(c)(2); see also Burgess, 537 F.3d at 128." (Emphasis supplied.) McIntyre v. Colvin, 758 F.3d 146 (2d Cir. 2014) The Court of Appeals for the Second Circuit found the ALJ’s failure to incorporate all of the plaintiff’s nonexertional limitations explicitly into the residual functional capacity (RCF) formulation or the hypothetical question posed to the vocational expert (VE) was harmless error. The court ruled that “an ALJ's hypothetical should explicitly incorporate any limitations in concentration, persistence, and pace.” 758 F.3d at 152. But in this case, the evidence demonstrated the plaintiff could engage in simple, routine tasks, low stress tasks despite limits in concentration, persistence, and pace; the hypothetical thus implicitly incorporated those limitations. The court also held that the ALJ’s decision was not internally inconsistent simply because he concluded that the same impairments he had found severe at Step two were not ultimately disabling. Cichocki v. Astrue, 729 F.3d 172 (2d Cir. 2013) The Court held the failure to conduct a function-by-function analysis at Step four of the Sequential Evaluation is not a per se ground for remand. In affirming the decision of the district court, the Court ruled that despite the requirement of Social Security Ruling (SSR) 96-8p, it was joining other circuits in declining to adopt a per se rule that the functions referred to in the SSR must be addressed explicitly. Selian v. Astrue, 708 F.3d 409 (2d Cir. 2013) The Court held the ALJ improperly substituted her own lay opinion by rejecting the claimant’s contention that he has fibromyalgia despite a diagnosis by his treating physician. It found the ALJ misconstrued the treating physician’s treatment notes. It criticized the ALJ for relying too heavily on the findings of a consultative examiner based on a single examination. It also found the ALJ improperly substituted her own criteria for fibromyalgia. Citing the guidance from the American College of Rheumatology now made part of SSR 12-2p, the Court remanded for further proceedings, noting the required finding of tender points was not documented in the records. The Court also held the ALJ’s RFC determination was not supported by substantial evidence. It found the opinion of the consultative examiner upon which the ALJ relied was “remarkably vague.” Finally, the court agreed the ALJ had erred in relying on the Grids to deny the claim. Although it upheld the ALJ’s determination that neither the claimant’s pain nor depression was significant, it concluded the ALJ had not affirmatively determined whether the claimant’s reaching limitations were negligible. Talavera v. Astrue, 697 F.3d 145 (2d Cir. 2012) The Court of Appeals held that for purposes of Listing 12.05, evidence of a claimant’s cognitive limitations as an adult establishes a rebuttable presumption that those limitations arose before age 22. But it affirmed the District Court, holding that while IQ scores in the range specified by the subparts of Listing 12.05 may be prima facie evidence that an applicant suffers from “significantly subaverage general intellectual functioning,” the claimant has the burden of establishing that she also suffers from qualifying deficits in adaptive functioning. The court described deficits in adaptive functioning as the inability to cope with the challenges of ordinary everyday life. | | | |  | An Interview With... ________________________________________________________________________________________________________ | | Connor O'Brien: From the Bench to Advocacy | | After more than 25 years of service and recent retirement as an Administrative Law Judge, Connor O’Brien has begun a new chapter as an Attorney Emeritus with Empire Justice Center. In this brief interview, Connor shares what drew her back into the legal world, how her experience from the bench shapes her advocacy today, and the unique insights she brings to the Disability Advocacy Program (DAP). What motivated you to transition from recent retirement as an ALJ to working as an attorney emeritus at Empire Justice Center? My decision to retire from federal service was primarily based on personal reasons; I am a new grandmother, I had been with the federal government for over 25 years, and Covid reminded us that life is short and unpredictable. After a few months of not knowing what day it is, however, I found that perhaps I needed more to engage me in our community. I have always had great respect for Empire Justice, and, after speaking with some folks from Empire Justice DAP, I decided to carve a niche for myself there. How do you think your experience as an ALJ influences the work you do within DAP now? I have enormous amount of experience in quickly reviewing a file and determining the basis for the claim, seeing what is missing, and finding a path for the claim. That said, I am finding that I still have a lot to learn about gathering evidence as the representative — the time that it takes to call sources and explain what we need and why. And the flaws in the ERE access are a surprise. I did not realize that the representative cannot simply click on the exhibit list and access the document. Perhaps educating both SSA and representatives on the differing levels of access and technology will help to create a smoother and more dynamic access in the future? | | | What legal issues or work do you find most compelling or rewarding within DAP? Ideally, I hope to assist the DAP program in streamlining our internal processes and developing templates for each level of the disability appeal process. Right now, we are short- staffed, and I am finding that 20 hours a week goes by quickly. What unique perspectives from your time as a judge do you think are most valuable to Empire Justice Center? Understanding the pressures put upon "judicially independent ALJs" — time constraints, expectations, expense limitations. OHO is a small part of a large, complex agency, and, because ALJs are often telling the Agency to change an earlier decision, ALJs are often seen as not contributing to the overall agency goals. How do you balance the more structured, formal nature of the judiciary with the often more flexible and advocacy-driven work in a nonprofit setting? It is not a balance really, more of a change in perspective. Fortunately, serving the public is paramount in both settings, so that is refreshingly consistent. Here, there is a luxury of time with each case, even though that may surprise folks! In your experience, how can advocates work alongside the courts to improve outcomes? Developing an easily followed format for pre-and post-hearing memos that gives the ALJ and the decision writer a roadmap to a favorable decision is essential. | | | | | | End Note ________________________________________________________________________________________________________ | |  | Sunday Scaries, Monday Blues | | The creeping sense of dread and unease on a Sunday evening? It is not just you. Many professionals experience a certain level of anxiety when the sun sets on their Sunday evening and they begin anticipating the scent of their Monday morning coffee. The next day’s to-do list begins to race through their mind like the closing credits of a film. This anxiousness has been coined as the “Sunday scaries” – a very real and common phenomenon. In fact, a recent Kickresume survey found 70% of workers feel anxious and experience pre-week stress before the work week, with 39% admitting they’ve taken sick days to cope. | | | Interestingly, it’s not job dissatisfaction driving the fear: 68% of respondents say they’re at least somewhat happy at work. Instead, the culprits behind the “scaries” stem from a mix of uncertainty, lack of control, and unclear expectations. To manage the anxiety, people turn to exercise, binge-watching, and, ironically, even working ahead during their free time. Fortunately, better work-life balance, clearer communication, and flexible schedules and work arrangements can help. And if nothing else, take comfort in this: Monday is only five days from Friday until a national three-day weekend becomes a reality! | | | | | | | | | | Disability Law News© Disability Law News© is published four times per year by: Empire Justice Center 1 West Main Street, Suite 200 Rochester, NY 14614 Phone: (585) 454-4060 The newsletter is written and edited by: Emilia Sicilia, Esq. Katherine Courtney, Esq. Ann Biddle, Esq. April 2025 issue. Copyright© 2025, Empire Justice Center All rights reserved. Articles may be reprinted only with permission of the authors. Available online at: www.empirejustice.org | | | | | | | | | |