Case Law Update: Figueroa Acevedo v. Commissioner - Court Reverses SSDI Denial That Skipped the Migraine Records

What happened

On September 15, 2026, a United States magistrate judge in the Middle District of Florida reversed the Commissioner of Social Security and sent a disability insurance benefits claim back to the agency in Katia I. Figueroa Acevedo v. Frank Bisignano, Commissioner of Social Security, No. 6:25-cv-1236-JRK (Orlando Division). It was docketed the next day, and judgment was entered on the docket on September 17, 2026. The court found that the administrative law judge left the claimant’s migraines out of the severe-impairment finding at step two, never discussed Social Security Ruling 19-4p, and barely mentioned the headache records anywhere in the decision. A sentence-four remand is not an award of benefits; the claim returns to the agency.

How the claim reached federal court

The claimant applied for disability insurance benefits in 2023, alleging she could not work as of July 1, 2022 because of postural tachycardia syndrome, hypertension, vertigo, gastroesophageal reflux, asthma, migraines, cognitive issues, and insomnia. The agency denied it initially and on reconsideration. An ALJ held a telephone hearing on March 26, 2025, with counsel and a vocational expert present, and found her not disabled on April 23, 2025. The Appeals Council denied review on May 13, 2025, making that the Commissioner's final decision, and she filed her federal complaint on July 8, 2025 under 42 U.S.C. section 405(g).

At step two the ALJ found five severe impairments: “fibromyalgia, disorder of the skeletal spine, neurocognitive disorder, anxiety, and depression.” Migraines were not on that list, and the order states the ALJ “did not discuss the migraines in any way at this step.” At step three the ALJ considered various listings but did not address Listing 11.02. The ALJ assessed a residual functional capacity for a reduced range of light work limited to simple tasks, found the claimant could not return to her past data processing work, and relied on the vocational expert to identify other jobs, including ticket taker and information clerk.

Why the court sent it back

The order walks through SSR 19-4p, the agency ruling on primary headache disorders. As the court explains, there is no listing that applies directly to migraine headaches, but the Administration “may find that a primary headache disorder, alone or in combination with another impairment(s), medically equals a listing.” Listing 11.02, the epilepsy listing, is the most analogous one. Paragraph B of that listing calls for dyscognitive seizures at least once a week for at least three consecutive months despite adherence to prescribed treatment; paragraph D calls for such seizures at least once every two weeks over the same period, plus a marked limitation in one area of functioning. To compare a headache disorder against those criteria, the ruling directs the agency to consider a detailed description from an acceptable medical source of a typical headache event, the frequency of events, adherence to treatment, side effects of treatment, and associated limitations in functioning.

The record was not thin. The claimant reported daily migraines with nausea, vomiting, blurred vision, light and noise sensitivity, dizziness, and fatigue; she testified she had often missed work at her last job because of migraines and other impairments, had resumed Botox injections and still had headaches daily, and wears sunglasses and is “constantly in a dark room” because of photosensitivity. Primary care records showed a regular migraine diagnosis and multiple medication trials. In February 2023 she reported the migraines were “out of control” and was referred for Botox. In November 2024 she reported severe headaches occurring “constantly” despite Botox, and in December 2024 she again reported “daily” headaches that were “worse” and described aggravating and relieving factors.

The court’s conclusion was that the record is “replete with evidence of Plaintiff’s migraine headaches, their frequency, aggravating and reliving factors, and treatment methods, almost none of which was considered or discussed by the ALJ.” The order goes on: “The ALJ’s findings are flawed to such a degree that judicial review is frustrated and reversal with remand is required. The ALJ’s discussion of the evidence does not assure the Court that Plaintiff’s migraine headaches were adequately considered at any step in the sequential evaluation.” The remand instructions are specific: reconsider whether the migraine headaches are severe at step two and at later steps, “ensuring explicit consideration of the matters set forth in SSR 19-4P.”

What this means if you have an SSDI claim involving headaches

This is one district court order on one record and does not decide anyone else’s claim. It does illustrate a few points worth knowing if headaches are part of your case.

A condition left off the step-two severe list is not supposed to disappear from the rest of the analysis. SSR 96-8p, which the order quotes, says an ALJ “must consider limitations and restrictions imposed by all of an individual’s impairments, even those that are not ‘severe.’” When a decision names an impairment once in passing and then never returns to it, a reviewing court may not be able to tell whether it was weighed at all.

The documentation SSR 19-4p asks for is specific and easy to leave out of a file: a description from an acceptable medical source of what a typical headache event looks like, how often events occur, whether prescribed treatment is being followed, what side effects the medications cause, and how the headaches interfere with activity during the day. Gaps on those points are rarely filled in on their own.

Finally, a remand is a second look by the agency, not a decision that benefits are owed. The claim returns to an ALJ to address the questions the court identified.

If your Social Security disability claim has been denied, our Social Security disability guide explains how the appeals process works, and you can request a free case evaluation. More rulings are on our case law updates page.

Case cited: Figueroa Acevedo v. Commissioner of Social Security, No. 6:25-cv-1236-JRK (M.D. Fla.), Doc. 21, dated Sept. 15, 2026. Current as of September 19, 2026.