“Substance, Not Labels” in Step-Two Severity: Omission of Chronic Pain Syndrome Is Harmless When the ALJ Evaluates Pain and Substantial Evidence Supports the RFC

1. Introduction

In Havice v. Bisignano (5th Cir. Feb. 6, 2026) (per curiam) (unpublished), Edward Alan Havice, a 56-year-old military veteran, sought Title II disability-insurance benefits alleging disabling back, hip, shoulder, and nerve pain beginning January 2022. The Social Security Administration (SSA) denied the claim at the initial and reconsideration levels. After a December 2023 administrative hearing, an Administrative Law Judge (ALJ) denied benefits in January 2024, finding Havice could perform his past relevant work (described as project manager/program director) and also could perform sedentary work. The Appeals Council denied review, making the ALJ’s decision final.

The central issue on judicial review was narrow but common in disability appeals: whether the ALJ committed reversible error by failing to identify chronic pain syndrome as a “severe impairment” in the written decision—and whether that omission prejudiced the claimant. The district court (S.D. Miss.) affirmed, and the Fifth Circuit affirmed again.

2. Summary of the Opinion

The Fifth Circuit held that substantial evidence supported the denial of benefits and that the ALJ’s failure to separately label chronic pain syndrome as a “severe impairment” did not warrant reversal. The court emphasized that the ALJ discussed Havice’s pain throughout the decision as a symptom of other severe impairments and that “substance, not labels, controls” when evaluating whether the ALJ adequately considered the claimant’s condition. Because Havice did not show prejudice—i.e., that the outcome would have differed—the alleged step-two omission was at most harmless.

3. Analysis

3.1. Precedents Cited (and How They Shaped the Decision)

  • Keel v. Saul, 986 F.3d 551 (5th Cir. 2021) and Whitehead v. Colvin, 820 F.3d 776 (5th Cir. 2016) (per curiam)
    Role: These cases supply the Fifth Circuit’s standard of review in Social Security cases: courts ask only whether (1) the decision is supported by substantial evidence and (2) the correct legal standards were used. The panel frames the entire appeal through this deferential lens.
  • Biestek v. Berryhill, 587 U.S. 97 (2019), quoting Consolidated Edison Co. v. NLRB, 305 U.S. 197 (1938), and citing Dickinson v. Zurko, 527 U.S. 150 (1999)
    Role: These Supreme Court authorities reinforce that the “substantial evidence” threshold “is not high,” anchoring the panel’s refusal to reweigh conflicting medical proof. They also underscore that appellate review is record-bound.
  • Johnson v. Bowen, 864 F.2d 340 (5th Cir. 1988) (per curiam)
    Role: Johnson supplies a Fifth Circuit articulation of substantial-evidence deference: reversal is inappropriate where “credible evidentiary choices” support the ALJ. The panel uses Johnson to validate affirmance despite competing evidence about pain.
  • Kneeland v. Berryhill, 850 F.3d 749 (5th Cir. 2017), quoting Audler v. Astrue, 501 F.3d 446 (5th Cir. 2007), and Jones v. Astrue, 691 F.3d 730 (5th Cir. 2012)
    Role: These cases provide the governing harmless-error/prejudice framework: “procedural perfection” is unnecessary, and the claimant bears the burden to show prejudice. This trio is the doctrinal basis for rejecting Havice’s step-two “labeling” argument absent a showing that the result would change.
  • Garcia v. Berryhill, 880 F.3d 700 (5th Cir. 2018)
    Role: Garcia is cited for the five-step sequential evaluation framework and the rule that a “not disabled” finding at any step ends the inquiry. It contextualizes why the step-four past-work finding is dispositive.
  • Shave v. Apfel, 238 F.3d 592 (5th Cir. 2001)
    Role: Shave supports the court’s pragmatic reading of ALJ decisions as a whole and the notion that multiple independently sufficient grounds can uphold a denial—reducing the force of a step-two omission when later steps address functional limits.
  • Prince v. Barnhart, 418 F. Supp. 2d 863 (E.D. Tex. 2005), citing Shave v. Apfel
    Role: Prince supplies the key “form-versus-substance” proposition quoted by the panel: an ALJ need not “name, enumerate, and discuss each factor” mechanically. This is directly deployed to reject the claim that chronic pain syndrome had to be separately labeled “severe.”
  • James J. Flanagan Stevedores, Inc. v. Gallagher, 219 F.3d 426 (5th Cir. 2000)
    Role: This case is cited for the related point that an ALJ need not specifically articulate every piece of supporting evidence or rejected evidence. It reinforces tolerance for concise ALJ drafting so long as the reasoning and support are discernible.
  • Leggett v. Chater, 67 F.3d 558 (5th Cir. 1995)
    Role: Leggett supports considering daily activities when evaluating symptom allegations, used here to buttress the ALJ’s reliance on Havice’s reported functioning.
  • Moore v. Sullivan, 919 F.2d 901 (5th Cir. 1990) (per curiam) and Bradley v. Bowen, 809 F.2d 1054 (5th Cir. 1987)
    Role: These cases confirm the ALJ’s role as the finder of fact who weighs medical opinions and credibility. The panel uses them to justify the ALJ’s decision to prefer state consultants’ conclusions over evidence suggesting pain would interfere with work.

3.2. Legal Reasoning

The opinion’s reasoning is structured around two interlocking moves: (1) deference under substantial-evidence review, and (2) harmless error / lack of prejudice.

A. Step Two “Severe Impairment” vs. Whole-Decision Review

Havice’s argument targeted step two: the ALJ found several severe impairments (shoulders, hip, spine, heart) but did not list chronic pain syndrome as its own severe impairment. The Fifth Circuit treated that as a labeling dispute, not a substantive failure to evaluate pain. The critical factual point was that the ALJ “discussed Havice’s pain in detail” throughout the decision as a symptom tied to the severe impairments already recognized.

The panel’s operative rule is captured in its phrasing: “Substance, not labels, controls.” Borrowing the idea (and quote) from Prince v. Barnhart (citing Shave v. Apfel), the court held the law does not demand a rigid, outline-style decision that separately names each possible impairment if the functional consequences are actually considered.

B. Prejudice/Harmless Error as the Decisive Filter

Even if one assumes a step-two omission, Fifth Circuit doctrine requires the claimant to demonstrate prejudice. Under Kneeland v. Berryhill (quoting Audler v. Astrue) and Jones v. Astrue, procedural imperfections do not justify reversal unless substantial rights are affected. Here, the court concluded Havice did not establish that adding “chronic pain syndrome” as a severe impairment would have altered the RFC or the step-four finding that he could perform past relevant work.

C. Substantial Evidence for the RFC and Step-Four Past Work Finding

The Fifth Circuit also affirmed on the ground that substantial evidence supported the ALJ’s functional findings:

  • Two state psychological consultants found only mild functional limitations and “no more than minimal work-related impairments.”
  • The ALJ cited Havice’s reported ability to perform personal and household tasks, consistent with 20 C.F.R. § 404.1529(c)(3)(i) and Leggett v. Chater.
  • While Havice offered evidence (including a doctor’s opinion) that pain could interfere with work, the ALJ was entitled to weigh competing opinions under Moore v. Sullivan and to reject a physician’s view when evidence supports a contrary conclusion under Bradley v. Bowen.
  • The ALJ relied on the “full record,” including MRI scans, admissions, and multiple medical opinions, to conclude Havice could perform past relevant work.

In short, the court declined to reweigh the record—precisely what Biestek v. Berryhill and Johnson v. Bowen caution against.

3.3. Impact

Although the opinion is “not designated for publication” under 5th Cir. R. 47.5 and thus is not binding precedent, it is a clear signal of how the Fifth Circuit continues to handle common Social Security arguments:

  • Step-two disputes are unlikely to succeed when the ALJ proceeds beyond step two and discusses the relevant symptoms (here, pain) in the RFC analysis. The court’s emphasis on “substance, not labels” encourages reviewing courts to read ALJ decisions holistically.
  • Harmless error is a high hurdle for claimants: under Jones v. Astrue, they must show prejudice—i.e., a plausible path to a different outcome.
  • Substantial-evidence deference remains robust: the “not high” evidentiary threshold from Biestek v. Berryhill continues to insulate ALJ determinations where the record contains reasonable support, even amid conflicting evidence.

4. Complex Concepts Simplified

  • Residual Functional Capacity (RFC): an administrative finding of the most a claimant can still do in a work setting despite limitations. (20 C.F.R. § 404.1545(a))
  • “Severe impairment” (Step Two): an impairment that significantly limits basic work activities. Step two is generally a screening step; if the ALJ identifies at least one severe impairment and continues, disputes over whether another condition should also be labeled “severe” often matter only if they change the RFC.
  • Five-step sequential evaluation: the SSA’s ordered decision process (work activity; severe impairment; listings; past relevant work; other work). A “not disabled” finding at any step ends the analysis. (20 C.F.R. § 404.1520; Garcia v. Berryhill)
  • Substantial evidence: not “more likely than not,” but enough relevant evidence that a reasonable mind could accept it as adequate. Courts do not retry the case; they check whether the agency’s choice is reasonably supported. (Biestek v. Berryhill)
  • Harmless error / prejudice: even if the ALJ made a mistake in articulation, reversal requires a showing that the mistake likely affected the result. (Kneeland v. Berryhill; Jones v. Astrue)
  • Past relevant work (Step Four): if the claimant can still perform prior qualifying work, the SSA finds the claimant not disabled. (20 C.F.R. § 404.1520(a)(4)(iv))

5. Conclusion

Havice v. Bisignano reinforces a practical appellate rule in Social Security litigation within the Fifth Circuit: failure to separately label a condition (here, chronic pain syndrome) as a “severe impairment” is not reversible error when the ALJ substantively evaluates the symptom evidence and the claimant cannot show prejudice. Grounded in the substantial-evidence standard and the claimant’s burden to demonstrate harm, the opinion underscores that disability appeals typically turn less on drafting formalisms and more on whether the ALJ’s functional findings are reasonably supported by the administrative record.