govinfo:USCOURTS-kywd-1_25-cv-00046-1

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UNITED STATES DISTRICT COURT 
WESTERN DISTRICT OF KENTUCKY 
BOWLING GREEN DIVISION 
CIVIL ACTION NO. 1:25-CV-00046-GNS-HBB 
 
 
JESSICA L. PLAINTIFF 
 
v. 
 
FRANK BISIGNANO, 
Commissioner of Social Security DEFENDANT 
 
 
ORDER 
 This matter is before the Court on Plaintiff’s Objection (DN 17) to the Magistrate Judge’s 
Findings of Fact, Conclusions of Law, and Recommendation (DN 16).   
I. BACKGROUND 
 On December 8, 2021, Plaintiff Jessica L. (“Plaintiff”) filed a protective application for 
social security disability insurance benefits.  (Admin. R. 185-87, 190 -96, DN 7).  Plaintiff 
alleged that her disability began on December 2, 2021 , due to fibromyalgia, bursitis of the 
shoulders and back, tendinitis of the shoulders and back, tendinosis of the should er and back, 
migraines or myofascial pain syndrome, depression, polycystic ovary syndrome  (“PCOS”), and 
irritable bowel syndrome  (“IBS”).  (Admin. R. 190, 209).  Her application was denied initially 
and again upon reconsideration.  (Admin. R. 72-73).  Plaintiff then requested and was granted a 
hearing with an Administrative Law Judge (“ALJ”).  (Admin. R. 103-104, 144-57). 
 Following the hearing, the ALJ issued a written decision determining that Plaintiff was 
not under a disability from December 2, 2021, through the date of the ALJ’s decision.  (Admin. 
R. 18-30).  After Plaintiff’s request for review of the ALJ’s decision was denied  by the Appeals 
Council, the ALJ’s decision became the final decision of the Commissioner of Social Security.  
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(Admin. R. 1 -7).  Plaintiff then filed this action appealing that decision.  (Compl., DN 1).  The 
matter was referred to the Magistrate Judge pursuant to 28 U.S.C. § 636(b)(1).  (R. & R. 1, DN 
16).  The Magistrate Judge filed a Report and Recommendation (“R. & R.”) in which it was 
recommended that the ALJ’s decision be affirmed and judgment be entered for the 
Commissioner.  (R. & R. 11).  Plaintiff objected to the R. & R.  ( Pl.’s Obj. R. & R., DN 17 
[hereinafter Pl.’s Obj.]. 
II. STANDARD OF REVIEW 
Upon timely objection to a Magistrate Judge’s proposed finding of fact and 
recommendations for disposition produced under 28 U.S.C. § 636(b)(1), the Court is generally 
required to “make a de novo determination of those portions of the report or specified proposed 
findings or recommendations to which objection is made .”  28 U.S.C. § 636(b)(1); accord Fed. 
R. Civ. P. 72(b)(3) (“ The district judge must determine de novo any part of the magistrate 
judge’s disposition that has been properly objected to. ”).  Ther e is an exception to this general 
rule, however, when an objection “merely incorporates portions of a [party]’s prior motion . . . .”  
United States v. Ickes, No. 1:15-CR-00004-GNS-2, 2017 WL 1017120, at *1 (W.D. Ky. Mar. 15, 
2017) (citation omitted).  Such an objection does not rise to the level of a “‘specific written 
objection[s] to the proposed findings and recommendations’ as required by Rule 72(b)(2).”  Id. 
(alteration in original) (citation omitted).  “[A] reexamination of the exact same argument that 
was presented to the magistrate judge without specific objections ‘wastes judicial resources 
rather than saving them, and runs contrary to the purpose of t he Magistrates Act.’”  Id. (quoting 
Howard v. Sec’y of Health & Hum. Servs. , 932 F.2d 505, 509 (6th Cir. 1991)).  When presented 
with an objection that only repeats arguments raised to the Magistrate Judge, the Court should 
review the objection only for clear error.  Id.; accord Manigaulte v. C.W. Post of Long Island 
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Univ., 659 F. Supp. 2d 367, 372 (E.D.N.Y. 2009) (“ [W]hen a party makes only conclusory or 
general objections, or simply reiterates his original arguments, the Court reviews the Report and 
Recommendation only for clear error.”   (alteration in original) ( citation omitted)).  “ Clear error 
will be found only when the reviewing court is left with the definite and firm conviction that a 
mistake has been committed.”  Max Trucking, LLC v. Liberty Mut. Ins. Corp., 802 F.3d 793, 808 
(6th Cir. 2015) (citing Anderson v. City of Bessemer City, 470 U.S. 564, 573 (1985)). 
In reviewing the administrative decision underlying a Magistrate Judge’s report and 
recommendation, the Court must consider:  “(1) ‘whether the findings of the ALJ are supported 
by substantial evidence’ and (2) ‘whether the ALJ applied the correct legal standards.’”  Chaney 
v. Kajikazi , No. 5:21 -CV-112-TBR, 2022 WL 3586213, at *2 (W.D. Ky. Aug. 22, 2022) 
(quoting Miller v. Comm’r of Soc. Sec. , 811 F.3d 825, 833 (6th Cir. 2016)).  “Substantial 
evidence is defined as more than a scintilla of evidence but less than a preponderance; it is such 
relevant evidence as a reasonable mind might accept as adequate to support a conclusion.”  Id. 
(internal quotation marks omitted) (quoting Rogers v. Comm’r of Soc. Sec. , 486 F.3d 234, 241 
(6th Cir. 2007)).  “When substantial evidence supports an ALJ’s decision, we affirm even if we 
would have decided differently and even if substantial evidence also supports the opposite 
conclusion.”  Id. (internal citations omitted) (quoting Francis v. Comm’r Soc. Sec. Admin. , 414 
F. App’x 802, 805 (6th Cir. 2011)). 
III. DISCUSSION 
 Plaintiff contends that the Magistrate Judge erred in concluding that the ALJ had properly 
evaluated her primary headache disorder under Social Security Ruling (“ SSR”) 19-4p and in 
conducting the Listing 11.02 analysis.  (Pl.’s Obj. 1 -3).  She asserts that the R&R failed to 
analyze whether the ALJ considered her photophobia, improperly relied on the results of an MRI 
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because it is not a diagnostic tool, and ignored more than two years of treatment notes 
documenting the lack of improvement from medication.  (Pl.’s Obj. 2-3). 
 At the third step, an ALJ must determine whether a claimant’s impairments are 
equivalent to a listing, but “20 C.F.R. § 404.1526 does not state that the ALJ must articulate, at 
length, the analysis of the medical equivalency issue.”  Bledsoe v. Barnart , 165 F. App’x 408, 
411 (6th Cir. 2006).  Rather, an “ ALJ should review all evidence of impairments to see if the 
sum of impairments is medically equivalent to a ‘listed impairment.’”  “There is no error if the 
ALJ does not make specific findings at Step Three so long as the ALJ makes sufficient factual 
findings elsewhere in the decision that support the ALJ’s Step Three conclusions.”  Marvich v. 
Comm’r of Soc. Sec., No. 4:23-CV-00833-DAC, 2024 WL 1075465, at *14 (N.D. Ohio Mar. 12, 
2024) (citing Forrest v. Comm’r of Soc. Sec., 591 F. App’x 359, 366 (6th Cir. 2014)).   
 Plaintiff contends that the ALJ failed to properly explain her analysis as Listing 11.00, 
including failing “to provide an explanation as to why migraines (which were a severe 
impairment) do not specifically meet the requirements of Listing 11.02.  (Pl.’s Obj. 2).   As this 
Court has noted: 
[T]he regulations do not specify how much discussion an ALJ must provide 
regarding those Listings as to which a substantial question is raised.  The Sixth 
Circuit has held that in evaluating whether a claimant has met or equaled a 
particular Listing, an ALJ must “actually evaluate the evidence, compare it to .  . . 
the [relevant] Listing, and give an explained conclusion, in order to facilitate 
meaningful judicial review.”  Reynolds v. Comm’r of Soc. Sec., 424 F. App’x 411, 
416 (6th Cir. 2011).  But the Court d oes not construe this as a heightened 
articulation requirement because, as the Sixth Circuit has also held, the applicable 
regulations only require the ALJ to consider whether the Listings are applicable; 
they do not require the ALJ to provide “good reasons” as in the context of the 
former treating physician rule.  Forrest v. Comm’r of Soc. Sec., 591 F. App’x 359, 
365 (6th Cir. 2014) (citing 20 C.F.R. §§ 404.1520(a)(3), (a)(4)(iii) and Bowie v. 
Comm’r of Soc. Sec. , 539 F.3d 395, 400 (6th Cir. 2008), as amen ded); Bledsoe v. 
Barnhart, 165 F. App ’x 408, 411 (6th Cir. 2006).  Nor do the applicable 
regulations regarding the Listings require an ALJ to explain how he or she 
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considered particular factors as they do in the context of the rules applicable to 
opinion evidence.  
 
Cynthia W. v. Comm’r of Soc. Sec. , No. 3:23 -CV-00559-CHL, 2025 WL 791637, at *4 (W.D. 
Ky. Mar. 12, 2025 (second and third alterations in original) (citing 20 C.F.R. § 404.1520c(b)(2)).  
“[A]n ALJ [is not required] to discuss every piece of evidence in the record.”  Showalter v. 
Kijakazi, No. 22-5718, 2023 WL 2523304, at *3 (6th Cir. Mar. 15, 2023) (citing Loral Def. Sys.-
Akron v. NLRB , 200 F.3d 436, 453 (6th Cir. 1999)); see also Kornecky v. Comm’r of Soc. Sec. , 
167 F. App’x 496, 508 (6th Cir. 2006) (“[A] n ALJ can consider all the evidence without directly 
addressing in his written decision every piece of evidence submitted by a party.  Nor must an 
ALJ make explicit credibility findings as to each bit of conflicting testimony, so long as his 
factual findings as a whole show that he implicitly resolved such conflicts. ”  (quoting Loral Def. 
Sys.-Akron, 200 F.3d at 453)).  The proper consideration is whether “the ALJ’s decision, read as 
a whole, somewhere ‘provide[s] a sufficient explanation for a court to determine the basis for 
[an] unfavorable finding about medical equivalence  . . . .’ ”  Id. at *5 (second alteration in 
original) (quoting Jandt v. Saul , No. 1:20 -CV-00045-HBB, 2021 WL 467200, at *9 (W.D. Ky. 
Feb. 9, 2021)).   
 In her decision, the ALJ analyzed whether Plaintiff’s impairments met any of the 
conditions in Listing 11.00.  (Admin. R. 23 -24).  While migraines are not a listed impairment, 
guidance from the Social Security Administration directs an ALJ to compare primary headache 
disorders with paragraphs B and D of Listing 11.02 to determine medical equivalency.  See SSR 
19-4p, 84 Fed. Reg. 44667, 44671 (Aug. 26, 2019).  Pursuant to SSR 19-4p, an ALJ is to conduct 
such an evaluation as follows: 
Paragraph B of listing 11.02 requires dyscognitive seizures occurring at least once 
a week for at least 3 consecutive months despite adherence to prescribed 
treatment.  To evaluate whether a primary headache disorder is equal in severity 
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and duration to the criteria in 11.02B, we consider:  A detailed description from 
an [acceptable medical source]  of a typical headache event, including all 
associated phenomena (for example, premonitory symptoms, aura, duration, 
intensity, and accompanying symptoms); the frequency of headache events; 
adherence to prescribed treatment; side effects of treatment (for example, many 
medications used for treating a primary headache disorder can produce 
drowsiness, confusion, or inattention); and limitations in functioning that may be 
associated with the primary headache disorder or effects of its treatment, such as 
interference with activity during the day (for example, the need for a darkened 
and quiet room, having to lie down without moving, a sleep disturbance that 
affects daytime activities, or other related needs and limitations). 
 
Id. 
 While Plaintiff contends that the ALJ overlooked her photophobia and failed to conduct a 
proper analysis at both steps three and four , the analysis for step three in the ALJ’s decision 
notes that “[s]ymptoms of primary headache disorder, such as photophobia, may cause a person 
to have difficulty sustaining attention and concentration.  I have included any related limitations 
in the residual functional capacity below in accordance with SSR 19 -4p.”  (Admin. R. 24).  The 
ALJ explained that “the claimant’s statements concerning the intensity, persistence and limiting 
effects of these symptoms are not entirely consistent with the medical evidence and other 
evidence in the record . . . .”  (Admin. R. 25).   At length, the ALJ discussed Plaintiff’s 
symptoms, her medical treatment (including medications), the report from the consultative 
examiner (Dr. Kathy Seigler), and the reports from the state agency medical consultants (Drs. 
Douglas Back and Christine Booth).  (Admin. R. 24 -28).  Drs. Back and Booth opined that 
Plaintiff’s migraine headaches were not equal to any of the limited impairment or qualified as a 
severe impairment.  (Admin. R. 68, 77).  Overall, t he ALJ’s decision reflects a review and 
consideration of Plaintiff’s medical treatment, including medications and surgery, and as the 
ALJ’s noted, Plaintiff’s symptoms improved with medication and following surgery.  (Admin. R. 
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27-28).  The ALJ found that Plaintiff’s impairments did not support a finding that her migraines 
met or medically equaled Listing 11.02.  (Admin R. 23).   
 Plaintiff is critical of the ALJ’s review of her treatment notes as to whether medication 
was a successful in reducing her migraines and asserts that “there are over two years of treatment 
notes where medication did not work . . . .”  (Pl.’s Obj. 3).  This is a general objection because 
Plaintiff does not cite to the treatment notes at issue in the record .  After receiving the record for 
clear error on this issue, the Court finds no mistake warranting reversal of the ALJ’s decision. 
 Plaintiff also takes issue with the use of an MRI as a diagnostic tool.  SSR 19 -4p, 
however, provides that “[t] o rule out other medical conditions that may result in the same or 
similar symptoms, a physician may also conduct laboratory tests or imaging scans. ”  SSR 19-4p, 
84 Fed. Reg. at 44669.  It further explains: 
[P]hysicians may use magnetic resonance imaging (MRI) to rule out other 
possible causes of headaches —such as a tumor —meaning that an unremarkable 
MRI is consistent with a primary headache disorder diagnosis.  . . . A scan may 
describe an incidental abnormal finding, which does not preclude the diagnosis of 
a primary headache disorder.  While imaging may be useful in ruling out other 
possible causes of headache symptoms, it is not required for a primary headache 
disorder diagnosis. 
 
Id. at 44669 (internal footnote omitted).   Thus, it is not improper to consider the results of an 
MRI in evaluating the evidence relating to Plaintiff’s claim for benefits. 
 The ALJ’s decision reflects a review and consideration of Plaintiff’s medical treatment, 
including medications and surgery, in making the RFC determination .  (Admin. R. 25-28).  That 
determination is consistent with t he record, which reflects that Plaintiff experience d some relief 
due to medication and surgery.  (Admin. R. 573, 628 -29, 633-634, 637, 784, 828).  As the Sixth 
Circuit has recognized, it is relevant for an ALJ to consider whether the claimant’s “symptoms 
often improved with medication and treatment” when evaluating her RFC at the fourth step.  See 
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Torres v. Comm’r, 490 F. App’x 748, 754 (6th Cir. 2012).  This evidence reflects that Plaintiff’s 
migraines did improve from medication and following surgery.  Overall, the record supports the 
ALJ’s determination.
IV. CONCLUSION
For the foregoing reasons, IT IS HEREBY ORDERED that Plaintiff’s Objection (DN 
17) is OVERRULED, the Magistrate Judge’s Findings of Fact, Conclusions of Law, and 
Recommendation (DN 16) is ADOPTED, and judgment is GRANTED for the Commissioner.  
The
 Clerk shall strike this matter from the active docket.
cc: counsel of record
March 31, 2026
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