Simone A. v. Commissioner of Social Security

Background

Simone A. sought Supplemental Security Income based on bipolar disorder, anxiety disorder or obsessive-compulsive disorder, and autism spectrum disorder. The Social Security Administration denied her application initially and on reconsideration. After a hearing at which Simone A. and a vocational expert testified, an administrative law judge found that she was not disabled. The Appeals Council denied review, and Simone A. sought judicial review under 42 U.S.C. § 405(g).

Medical-opinion evidence

The court held that the administrative law judge did not adequately explain why the opinions of Dr. Bhandari and Psychiatric Nurse Horn were unpersuasive. The administrative law judge relied on allegedly normal mental-status findings and stated that the providers’ opinions were based on Simone A.’s self-reports, but did not identify substantial evidence that contradicted the providers’ findings. The court also found that the decision did not explain why Simone A.’s self-reports supported some moderate limitations but did not support the providers’ opinions.

The court concluded that the administrative law judge improperly relied on isolated positive observations, such as Simone A. appearing pleasant or cooperative, while overlooking other evidence of abnormal mood, affect, severe symptoms, and suicidal thoughts. The court also found that certain cognitive-test results did not support characterizing her mental findings as normal, particularly because the examiner reported low-average scores in several areas and a full-scale IQ of 84.

Symptom testimony

The administrative law judge accepted that Simone A.’s impairments could reasonably cause her alleged symptoms but rejected her testimony about their intensity, persistence, and limiting effects. The court found that the stated reasons were not supported by substantial evidence. Those reasons included allegedly normal mental-status examinations, Simone A.’s self-employment as a certified health coach, her completion of an undergraduate degree, her apparent noncompliance with prescribed treatment, and her presentation at the hearing.

The court explained that the record did not show enough about the nature or extent of Simone A.’s self-employment to support relying on it. The decision also did not adequately account for her testimony that she had left an earlier degree program during a manic episode and later completed a degree in a program that provided substantial support. Regarding treatment noncompliance, the court found that the administrative law judge did not address evidence that Simone A.’s mental illness might itself have contributed to that noncompliance. Her responsive and coherent hearing presentation could not, by itself, support rejecting her symptom testimony.

Other arguments and remedy

The court declined to decide whether the administrative law judge was required under the newer regulations to explain how he evaluated the function report submitted by Simone A.’s mothers. The court also did not reach the argument concerning the administrative law judge’s step-five determination, because the errors involving the medical evidence and symptom testimony required remand.

The court rejected Simone A.’s request for an immediate award of benefits. It found that the record was not fully developed, unresolved issues remained, and it was not clear that properly evaluating the medical opinions and symptom testimony would require a finding that Simone A. was disabled. The court therefore reversed the administrative law judge’s decision and remanded for further proceedings. The order disposed of Docket Nos. 11 and 13.