Higgins v. Commissioner of Social Security
Eleventh Circuit (2025)

Introduction

The Eleventh Circuit’s non-published decision in Melanie Higgins v. Commissioner of Social Security ushers in a pragmatic clarification on two recurring issues in Social Security disability cases:

1. How an Administrative Law Judge (“ALJ”) may apply Social Security Ruling 12-2p when evaluating subjective complaints stemming from fibromyalgia, a condition notorious for its paucity of objective medical markers, and
2. The degree of specificity required when an ALJ assigns a numerical “off-task” percentage—here, ten percent—to accommodate restroom use or similar functional limitations.

Melanie Higgins, a Florida claimant suffering from multiple ailments—most prominently fibromyalgia, degenerative disc disease, and pelvic-floor disorders—sought disability insurance benefits and supplemental security income. After an ALJ and the district court rejected her claims, she appealed to the Eleventh Circuit arguing (i) the ALJ improperly discounted her fibromyalgia testimony and (ii) the ten-percent off-task finding lacked evidentiary support. The Court affirmed.

Summary of the Judgment

The Eleventh Circuit held that:

• The ALJ appropriately followed SSR 12-2p when assessing Higgins’s fibromyalgia. The ALJ relied on a combination of objective findings, treatment history, and daily activities—rather than “solely” on the absence of laboratory signs—when partially discrediting Higgins’s pain testimony.
• Substantial evidence supported the residual functional capacity (“RFC”) determination, including the allowance that Higgins could be off-task up to ten percent of the workday for restroom needs. Although the ALJ did not provide mathematical calculations, the decision articulated an adequate rationale grounded in the medical record (rectocele diagnosis, complaints of chronic diarrhea, multiple benign colonoscopies).
• Because the RFC still permitted work as a garment sorter and mail-sorter clerk—occupations existing in significant numbers—the denial of benefits stood.

Analysis

A. Precedents Cited and Their Influence

• Malak v. Commissioner of Social Security, 131 F.4th 1280 (11th Cir. 2025) – Reinforces that appellate review asks whether the ALJ applied correct legal standards and whether substantial evidence supports findings.
• Moore v. Barnhart, 405 F.3d 1208 (11th Cir. 2005) – Warned that credibility findings in fibromyalgia cases cannot rely solely on lack of objective proof. The panel invoked Moore to show the ALJ complied by cross-referencing activities and treatment responses.
• Winschel v. Commissioner of Social Security, 631 F.3d 1176 (11th Cir. 2011) – Requires ALJs to state reasons with “some measure of clarity.” The Court found the ALJ’s explanation of the ten-percent figure sufficient under Winschel.
• SSR 12-2p (2012) – The central interpretive rule for fibromyalgia disability claims. The Eleventh Circuit endorsed the ALJ’s two-step compliance: (1) confirm a medically determinable impairment and (2) evaluate intensity/persistence of symptoms in light of the full record.

B. Legal Reasoning

1. Threshold Showing of Disability — The Pain Standard
   Higgins satisfied the initial “pain standard” by identifying a medically determinable impairment (fibromyalgia). The dispute centered on whether her claimed limitations were credible.
2. SSR 12-2p Applied Correctly
   The ruling instructs that when objective evidence is scant:
   • ALJs should scrutinize consistency across the record, including daily activities, longitudinal treatment, medication efficacy, and clinical observations.
   • Objective shortfalls alone cannot negate credibility.
   The Court found the ALJ did precisely that—contrasting Higgins’s statements (unable to walk more than five minutes, must recline much of the day) with evidence of hiking, weekly church attendance, normal motor strength, and successful steroid injections.
3. Off-Task Quantification
   The Eleventh Circuit recognized the practical difficulty of converting restroom frequency into workday percentages. It held that an ALJ may settle on a reasonable estimate—here, ten percent—when:
   • The estimate is explicitly tied to documented impairments (rectocele, diarrhea complaints); and
   • No contrary medical opinion quantifies a higher limitation.
   Absent claimant-produced evidence demanding a larger allowance, the ALJ’s figure cleared the Winschel clarity threshold and was “reasonable to a fact-finder.”

C. Potential Impact

1. Guidance for Fibromyalgia Claimants – Claimants must supplement subjective pain testimony with corroborating treatment notes or functional assessments; merely pointing to a fibromyalgia diagnosis is insufficient in the Eleventh Circuit.
2. ALJ Discretion in Off-Task Assessments – The decision tacitly approves “ballpark” off-task percentages so long as (i) the ALJ connects them to record evidence and (ii) the percentage is favorable—or at least not prejudicial—relative to the claimant’s own proof.
3. Litigation Strategy – Counsel who wish to argue for >10% off-task should marshal gastroenterology reports, timed restroom studies, or vocational expert testimony quantifying work-place impact. Failure to do so may now invite ready affirmance.
4. Administrative Efficiency – The ruling encourages ALJs to state concise reasoning without the need to engineer precise minute-by-minute breakdowns, reducing procedural reversals on technical grounds.

Complex Concepts Simplified

• Residual Functional Capacity (RFC): The most a claimant can still do despite physical or mental limitations, expressed in work-related terms (e.g., “light work,” “must alternate sit/stand every 30 minutes”).
• “Off-Task” Time: Portions of the workday when an employee cannot perform required duties (e.g., extra restroom breaks). Vocational experts generally testify that exceeding ~15% off-task renders most jobs untenable.
• Substantial Evidence: Not “beyond a reasonable doubt,” but enough relevant evidence that a reasonable person could agree with the ALJ. Courts may not re-weigh—even if they would find differently—so long as this low threshold is met.
• SSR 12-2p: The Social Security Administration’s blueprint for evaluating fibromyalgia claims. Step 1: confirm a medically determinable impairment through trigger-point testing or similar. Step 2: weigh claimant’s statements against the holistic record.

Conclusion

Higgins consolidates Eleventh Circuit doctrine on two fronts. First, it underscores that SSR 12-2p requires a balanced, record-wide examination—objective findings plus activities, treatment response, and longitudinal consistency—when judging fibromyalgia credibility. Second, it validates ALJ discretion in assigning an “off-task” percentage without granular arithmetic if the figure is grounded in the evidence and uncontroverted by stronger proof. Lawyers representing disability claimants, particularly those with fibromyalgia or gastrointestinal comorbidities, must therefore:

• Develop objective or quasi-objective corroboration (e.g., functional capacity evaluations, detailed treatment logs) to buttress subjective symptoms.
• Present concrete vocational or medical evidence when advocating for significant off-task allowances.

In the broader legal landscape, the decision promotes administrative pragmatism and sets a persuasive (albeit unpublished) precedent that other circuits and district courts may cite when similar arguments arise.