Madkins v. Bisignano: Lessons from the Fifth Circuit on Disability Claims

Madkins, a machine operator, suffered back problems, carpal tunnel syndrome, and depression after a work injury. He applied for Social Security Disability benefits but was denied at every stage.

The district court eventually remanded the case, instructing the ALJ (Administrative Law Judge) to reconsider certain medical opinions. After a new hearing, the ALJ denied benefits again, and this time the Fifth Circuit upheld the decision.

Key Issues on Appeal

Ignored Medical Opinion: Dr. Prosser’s Evaluation

• Plaintiff argued that the ALJ failed to consider Dr. Prosser’s psychological assessment.

• Dr. Prosser noted “moderate limitations” in social interaction.

• The ALJ found Madkins could interact with people “frequently” (about one-third to two-thirds of a workday).

• The Fifth Circuit ruled this wasn’t a meaningful conflict—so no harm, no reversal.

  
  

Treating Doctor’s Inconsistencies: Dr. Booker’s Restrictions

• Dr. Booker imposed significant limitations on Madkins’s abilities.

• However, his opinions were inconsistent across reports:

  • At one point, climbing stairs improved while twisting worsened, with no explanation.

  • He also claimed Madkins would be off-task 25% of the workday but didn’t provide medical reasoning.

• The ALJ discounted these opinions, and the Court agreed.

  
  

Takeaways for Disability Claimants

Q: Does proving an ALJ made an error automatically win your case?

A: No. You must show the error actually harmed your client’s case.

Q: How do treating physician opinions hold up in court?

A: Only if they are consistent, well-supported, and medically explained. Inconsistencies or unexplained restrictions can undermine credibility.

Q: What should claimants and attorneys watch for before a hearing?

A:

• Make sure treating doctors explain changes in their opinions.

• Ensure medical opinions have a clear basis in records.

• Be prepared for the ALJ to highlight and rely on inconsistencies.

  
  

Why This Case Matters

Madkins v. Bisignano highlights an important reality: not every ALJ mistake equals a win on appeal. Courts require proof that the mistake materially affected the outcome. For disability claimants, preparation and consistency in medical evidence are crucial.

Got any questions? Schedule a consultation with us. I’m here to help. It’s a lot to take in, but we’ll get through it together. After all, navigating these waters is always easier when you’ve got someone to chat with.