Adriana de la Torre, NOSSCR Sustaining Member

If you litigate SSD cases in the Fourth Circuit, Hultz v. Bisignano is one of those decisions you want bookmarked, highlighted, and ready to cite.

At a basic level, Hultz is a reminder of something we all know, but still see ignored far too often: fibromyalgia cases cannot be evaluated like other impairment cases. And more importantly, this is not optional.

Same Mistake, Different Case

The ALJ in Hultz did what we still see regularly in fibromyalgia claims: discounted the claimant’s testimony because it wasn’t “consistent with the medical evidence.” That phrasing alone should raise red flags after Arakas v. Commissioner, which was a published decision from the Fourth Circuit in December 2020.

The Fourth Circuit had little patience for the ALJ’s handling of fibromyalgia. The court reiterated what Arakas already made clear: fibromyalgia does not produce objective medical evidence, and ALJs may not rely on the absence of such evidence, even as one factor, to discredit a claimant’s subjective symptoms.

No balancing. No caveats. No “along with other reasons.” If objective evidence is doing any work in a fibromyalgia credibility analysis, the analysis is legally flawed.

Why the Remedy Is the Real Story

What makes Hultz stand out isn’t just the error finding, it’s what the court did next.

Instead of remanding for another hearing, the majority reversed outright and ordered calculation of benefits. That’s a big deal, and it tells us something important about how the Fourth Circuit is viewing these cases.

Once the court removed the improper demand for objective proof, the remaining record pointed consistently in one direction:

• Years of documented chronic pain and fatigue
• Treating rheumatology records repeatedly attributing symptoms primarily to fibromyalgia
• Credible third-party testimony from the claimant’s grandmother
• A condition that predictably waxes and wanes, making isolated “good days” legally meaningless

In other words, there was nothing left for a new ALJ to fix. The denial rested on a credibility analysis that violated Arakas from the ground up.

The Court Pushes Back on Familiar ALJ Reasoning

The opinion also dismantles several justifications that routinely show up in fibromyalgia denials:

• Temporary improvement is not sustained functional capacity.
• Gaps in treatment are not evidence that symptoms resolved, especially where the condition is chronic and untreatable.
• Daily activities are not proof of full-time competitive work, particularly when they are sporadic and followed by significant rest or flare-ups.

None of this is new, but Hultz reinforces that relying on these points to undermine subjective symptoms doesn’t just weaken a decision. It can invalidate it entirely.

Treating Sources: Less Paperwork, More Reality

On the treating-source issue, the ALJ discounted the rheumatologist’s opinion because the doctor didn’t quantify limitations on a form and because of treatment gaps. The Fourth Circuit wasn’t persuaded.

The court emphasized something practitioners often argue but don’t always see adopted: substance matters more than form. Longitudinal observations, consistency with the overall record, and an understanding of fibromyalgia carry more weight than whether a doctor filled out every box neatly.

The Dissent Highlights the Ongoing Tension

Judge Agee’s partial dissent is worth reading. He agreed the ALJ violated Arakas, but warned that awarding benefits without remand risks turning fibromyalgia into a de facto per se disability.

That concern reflects a real tension in these cases: how much deference courts owe ALJs versus how aggressively courts should enforce claimant protections when credibility errors infect the entire decision.

The majority’s response was practical: this record didn’t need another hearing. The problem wasn’t underdevelopment, it was legal error.

Why Hultz Matters in Practice

For advocates, Hultz strengthens several key points:

• Arakas violations are not harmless
• Credibility errors in fibromyalgia cases can justify outright reversal, not just remand
• Consistent subjective complaints, corroborating lay testimony, and the nature of the condition itself matter more than isolated improvement or treatment gaps

If your fibromyalgia case hinges on subjective symptoms, and realistically, it always will, Hultz v. Bisignano is powerful authority for the proposition that some errors can’t be cured with another hearing.

Sometimes, the record is already enough.

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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.

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The views and opinions expressed in this article are the author’s own and do not necessarily reflect the views of NOSSCR, its leadership, or staff.