Elizabeth S. v. Saul

Background

Elizabeth S. sought judicial review under 42 U.S.C. § 405(g) of an Administrative Law Judge’s decision denying her disability benefits. She alleged disability based on sleep apnea, depression and other mental-health conditions, anxiety, panic disorder, and degenerative or inflammatory arthritis. The Administrative Law Judge found severe impairments including substance-use disorder, rheumatoid or osteoarthritis, carpal tunnel syndrome, affective and anxiety disorders, and cognitive disorder.

The Administrative Law Judge initially determined that Elizabeth S. would have no jobs available if her substance use were included in the disability analysis. The judge then evaluated whether her drug and alcohol use was a material contributing factor. The judge found that, if she stopped using substances, she would retain the ability to perform light work with restrictions and could return to her past work as a deli clerk or cashier. The judge therefore concluded that her substance use was material and that she was not disabled under the Social Security Act.

Arguments and Analysis

Elizabeth S. argued that the Administrative Law Judge incorrectly found that her arthritis did not meet Listing 14.09 for inflammatory arthritis. She also argued that her mental impairments met Listings 12.03, 12.04, 12.05, or 12.06; that the substance-use materiality analysis was unsupported; that the residual functional capacity finding was incorrect; and that the Administrative Law Judge should have used the Medical-Vocational Guidelines.

The court upheld the finding on Listing 14.09. It explained that a diagnosis alone does not satisfy a listing; the claimant must also show the specific severity and functional limitations required by the listing. The court agreed that the Administrative Law Judge had supported his decision to give little weight to restrictive opinions from Dr. Ferguson and Dr. Khan. Those opinions were viewed as inconsistent with other examinations showing full strength, generally preserved range of motion, limited objective findings, conservative treatment, gaps in treatment, and inconsistent compliance with treatment recommendations.

The court also upheld the findings concerning the mental-health listings. The Administrative Law Judge found only mild or moderate limitations in the four areas of mental functioning used for the relevant listings: understanding and applying information, interacting with others, concentrating and maintaining pace, and adapting or managing oneself. The court concluded that substantial evidence supported the decision to give little weight to opinions from Dr. Aames; Dr. Sakhai and LMFT Neumann; Dr. Howard; and Dr. Franklin and Childs. The court cited inconsistencies between those opinions and treatment notes, examinations, reported daily activities, objective observations, and evidence that the opinions did not adequately account for substance use or treatment noncompliance.

For Listing 12.05, concerning intellectual disorder, the court agreed that the record did not show the required intellectual or adaptive-functioning deficits before age 22. Elizabeth S.’s failure to graduate from high school, by itself, did not establish that she met the listing, particularly because the record also reflected some college or certification coursework and reports of good grades.

The court further upheld the substance-use materiality finding. It found substantial evidence of alcohol and cocaine use during the relevant period, including reports to treatment providers of continued or recent use. The court concluded that Elizabeth S. had not provided sufficient evidence showing that her substance use was not a material contributing factor to her disability. Because the Administrative Law Judge determined that she could perform her past work without substance use, the court held that the materiality finding was supported.

Finally, the court rejected the challenges to the residual functional capacity finding because the Administrative Law Judge properly discounted the more restrictive physical assessments. It also rejected the argument about the Medical-Vocational Guidelines because the Administrative Law Judge’s conclusion that Elizabeth S. could perform her past work occurred at step four, before those guidelines would apply at step five.

Disposition

The court denied Elizabeth S.’s motion for summary judgment and granted the Commissioner’s cross-motion for summary judgment. It directed that a separate judgment be entered and that the Clerk terminate the case.