Third Circuit Endorses “Dispositive-Reasons” Review: No Requirement to Itemize Symptom Test Scores and Explicit “Magic Words” When Evaluating Mental Impairments and Medical Opinions

1. Introduction

In Lori Facer v. Commissioner Social Security (3d Cir. Jan. 20, 2026) (nonprecedential), the Court of Appeals for the Third Circuit affirmed a district court judgment upholding the Social Security Administration’s denial of Disability Insurance Benefits. The appellant, Lori Jane Facer, alleged disability beginning June 27, 2020 after a 2018 motor-vehicle accident and concussion, citing both physical and mental impairments (including anxiety, depression, and PTSD). The Administrative Law Judge (“ALJ”) found at least one severe physical impairment, found the mental impairments non-severe at step two, and concluded at step four that Facer could return to past relevant work as a phlebotomist (with a driving restriction in the residual functional capacity (“RFC”)).

The appeal centered on two related themes: (1) whether substantial evidence supported the ALJ’s step-two finding that mental impairments caused no more than minimal functional limitation, and (2) whether the ALJ properly evaluated mental-health opinion evidence—particularly a counselor’s checkbox-style functional assessment and a state-agency psychological consultant’s findings—when formulating RFC and the step-four past-work determination.

2. Summary of the Opinion

The Third Circuit held that substantial evidence supported the ALJ’s determinations. It emphasized:

  • The ALJ permissibly relied on objective mental-status examinations and longitudinal treatment observations describing largely normal functioning (e.g., intact cognition/memory, euthymic mood, normal thought process, excellent insight/judgment, good attention/concentration), even though symptom screeners reflected “severe” self-reported symptoms.
  • The ALJ was not required to discuss each specific test score (PHQ-9, GAD-7, PTSD screening) where the decision made clear those materials were considered and where the explanation addressed the dispositive reasons for the outcome.
  • In weighing medical opinions under the current regulatory framework, the ALJ adequately addressed supportability and consistency—and need not repeat “magic words”—so long as the reasoning is explained and grounded in the record.
  • The ALJ reasonably found the counselor’s and consultant’s “moderate/marked” limitation opinions unpersuasive because they conflicted with contemporaneous treatment notes and other cited record evidence.

The court therefore affirmed the denial of benefits.

3. Analysis

3.1 Precedents Cited

Hagans v. Comm'r of Soc. Sec., 694 F.3d 287 (3d Cir. 2012)

The panel invoked Hagans for the governing standard of appellate review: legal issues are reviewed de novo, but the ALJ’s factual findings are upheld if supported by substantial evidence. This framing matters because Facer’s challenges largely sought reweighing of evidence (symptom scores and competing opinion evidence), which is generally foreclosed under substantial-evidence review.

Biestek v. Berryhill, 587 U.S. 97 (2019) and Consol. Edison Co. of New York v. N.L.R.B., 305 U.S. 197 (1938)

The opinion quotes Biestek—which in turn quotes Consol. Edison—to define “substantial evidence” as “such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” The court used this principle to validate the ALJ’s reliance on objective clinical observations and functional activities, even where other evidence (self-reported symptom severity) might support a different conclusion. The key move is that the ALJ’s view only had to be reasonable, not the best or only plausible interpretation.

Zirnsak v. Colvin, 777 F.3d 607 (3d Cir. 2014)

Zirnsak supplied two important propositions. First, it restated the claimant’s burden to show inability to do past relevant work and any other work existing in the national economy (within the statutory framework). Second, the panel cited Zirnsak for the proposition that an ALJ may accept some medical evidence and reject other evidence so long as the ALJ explains the basis for discounting the rejected evidence. This directly supported the ALJ’s decision to find portions of Foreman’s and Dr. Mancini’s opinions unpersuasive due to inconsistencies with the broader record and even with their own notes.

Zaborowski v. Comm'r of Soc. Sec., 115 F.4th 637 (3d Cir. 2024)

Zaborowski is the central contemporary authority the panel used to affirm the ALJ’s articulation. The decision relies on two Zaborowski themes:

  • “Dispositive reasons” suffices: ALJs must explain the reasons for their decisions, but need not explain “everything else that they considered.” Applied here, the ALJ did not need to specifically list PHQ-9, GAD-7, and PTSD scores if the narrative analysis shows they were not ignored and the decision explains why objective exams and longitudinal functioning drove the severity/RFC findings.
  • No “magic words” requirement: Under the post-2017 medical-opinion regulations, supportability and consistency are the most important factors, but an ALJ can “weave” those concepts throughout the discussion and need not mechanically recite “supportable” and “consistent” for each source so long as the rationale is clear.

Newell v. Commissioner of Social Security, 347 F.3d 541 (3d Cir. 2003)

Facer relied on Newell for the proposition that step two is a de minimis screening device intended to dispose of groundless claims. The panel effectively neutralized this argument in two ways. First, it noted that the ALJ found severe physical impairments and therefore proceeded beyond step two. Second, it indicated that any alleged step-two error regarding mental impairments would be harmless because the ALJ proceeded with the sequential evaluation and considered mental impairments later.

Ray v. Berryhill, 915 F.3d 486 (7th Cir. 2019); Buck v. Berryhill, 869 F.3d 1040 (9th Cir. 2017); but see Nicola v. Astrue, 480 F.3d 885 (8th Cir. 2007)

These cases were cited in a brief cross-circuit discussion of harmless error at step two. Ray and Buck represent the widely adopted view that once an ALJ finds at least one severe impairment and continues the analysis, an error in labeling another impairment “non-severe” is often harmless if the ALJ later considers all impairments when assessing RFC. The “but see” citation to Nicola acknowledges that not all circuits treat step-two error the same way, underscoring that the harmless-error approach is context dependent (i.e., whether the impairment’s functional effects were actually accounted for later).

3.2 Legal Reasoning

(a) Step Two: Non-severe Mental Impairments Supported by Objective Observations

The court focused on the ALJ’s application of the “paragraph B” functional-area framework (the four broad domains of mental functioning referenced by regulation) and the ALJ’s detailed record review. While Facer’s symptom screenings rated PTSD/depression/anxiety as “severe” based on self-report, the ALJ emphasized repeated mental status findings—intact memory/cognition, euthymic mood, normal thought process, excellent insight/judgment, good attention and concentration—that tended to indicate limited functional restriction. Under substantial-evidence review, the appellate question was not whether a different factfinder could have credited the symptom ratings more heavily, but whether the ALJ’s chosen interpretation had adequate evidentiary support. The panel held it did.

(b) No Requirement to Itemize PHQ-9/GAD-7/PTSD Scores

The court rejected the argument that the ALJ committed reversible error by not specifically referencing each screening score. Relying on Zaborowski v. Comm'r of Soc. Sec., the panel reiterated that ALJs must explain the dispositive reasons for their conclusions, not provide an inventory of every item reviewed. The court found the decision sufficiently demonstrated that the ALJ did not ignore the tests and permissibly treated them as self-reported symptom evidence weighed against objective examinations and observed functioning.

(c) Step Four/RFC: Opinion Evaluation Through Consistency and Supportability

Under 20 C.F.R. § 404.1520c(a), “supportability” and “consistency” are the most important factors in evaluating medical opinions. The panel emphasized that an ALJ may address these factors implicitly through reasoning, without repeating “magic words,” so long as the explanation connects the opinion weight to record evidence.

Here, the ALJ discounted (i) counselor Madison Foreman’s checkbox assessment indicating various “moderate,” “marked,” and “extreme” limitations and predicted absenteeism, and (ii) Dr. Mancini’s state-agency assessment of certain “moderate” limitations. The ALJ’s rationale, as accepted by the panel, was that these limitations were inconsistent with treatment notes—including Foreman’s own contemporaneous notes—reflecting intact memory, normal insight/judgment, good attention/concentration, and intact functional status. As to Dr. Mancini, the ALJ found internal inconsistency between the moderate limitations and the portions of the record Dr. Mancini cited.

The court also rejected Facer’s argument that the ALJ was required to explicitly discuss the “consistency” between Foreman and Dr. Mancini (i.e., that both suggested some degree of impairment). The panel treated the ALJ’s task as assessing each opinion’s supportability and consistency with the record as a whole, not tallying agreement among sources when that agreement itself conflicts with objective findings.

3.3 Impact

Although designated nonprecedential (and therefore not binding under Third Circuit I.O.P. 5.7), the opinion is practically significant in three ways:

  • Articulation expectations remain modest: Echoing Zaborowski v. Comm'r of Soc. Sec., the decision reinforces that ALJs are not required to catalog every test score or piece of evidence, particularly where the evidence is cumulative or non-dispositive.
  • Symptom screeners vs. mental status exams: The case underscores that self-reported severity ratings (PHQ-9, GAD-7, PTSD screens) may be discounted when longitudinal objective examinations and observed functioning are largely normal—so long as the ALJ explains the reasoning.
  • Post-2017 opinion rules in practice: The opinion exemplifies how courts may accept “woven” discussion of supportability/consistency and uphold discounting of checkbox or conclusory limitations when contemporaneous notes do not reflect comparable functional deficits.

For future litigants, the decision signals that appellate success is unlikely where the challenge is chiefly that the ALJ did not mention particular scores or did not use specific regulatory vocabulary, absent a showing that functional limitations were ignored or that the ALJ’s explanation cannot be traced to the record.

4. Complex Concepts Simplified

  • “Substantial evidence”: Not “more likely than not,” and not “beyond doubt.” It means enough relevant evidence that a reasonable person could agree with the ALJ—even if other evidence points the other way.
  • Step two (“severe impairment”): A screening step asking whether an impairment causes more than minimal limitation in basic work activities. Even if an impairment is labeled “non-severe,” it still must be considered later when assessing RFC if it causes any limitation.
  • RFC (Residual Functional Capacity): The most a claimant can still do in a work setting despite all medically supported limitations (physical and mental). It is used at steps four and five.
  • Supportability vs. consistency (medical-opinion rules):
    • Supportability asks: Does the source explain the opinion with objective findings and reasoning?
    • Consistency asks: Does the opinion fit with other evidence in the record?
  • Harmless error (step two): Even if the ALJ arguably should have called an impairment “severe,” the mistake may not matter if the ALJ found some other severe impairment and still evaluated all limitations in later steps.

5. Conclusion

Lori Facer v. Commissioner Social Security affirms a denial of benefits by applying a deferential substantial-evidence lens and by reinforcing a pragmatic approach to ALJ explanation. The Third Circuit endorsed that an ALJ may (1) find mental impairments non-severe where objective mental-status findings and observed functioning are largely normal notwithstanding severe self-reported symptom scores, and (2) evaluate medical opinions without reciting “magic words,” so long as the rationale reflects supportability and consistency and explains why certain limitations are unpersuasive. Even as a nonprecedential disposition, the opinion illustrates how Zaborowski v. Comm'r of Soc. Sec. is shaping the Third Circuit’s expectations for ALJ articulation and the judicial review of mental-impairment evidence.