M.D. v. Kijakazi

Background

M.D. sought judicial review of the Commissioner of Social Security’s final decision denying her applications for disability insurance benefits and supplemental security income. The administrative law judge found that M.D. was disabled when considering all of her impairments, but found that her alcoholism was a contributing factor material to the disability determination. The judge therefore concluded that M.D. would not be disabled if she stopped using alcohol.

M.D. challenged the administrative law judge’s treatment of three categories of evidence: the opinions of her treating psychiatrist, Dr. Jee Hyun Guss, and medical expert Dr. David Glassmire; M.D.’s testimony about the severity of her symptoms; and testimony from her mother, D.D. M.D. also requested a remand directing an immediate award of benefits under the Ninth Circuit’s credited-as-true rule.

Medical opinions

The court held that the administrative law judge did not apply all of the regulatory factors required when weighing Dr. Guss’s treating-source opinion. Those factors include the treatment relationship, examination frequency, supportability, consistency, and the doctor’s specialization. The court also held that the administrative law judge did not provide specific and legitimate reasons, supported by substantial evidence, for discounting Dr. Guss’s opinion.

The court rejected the administrative law judge’s reliance on M.D.’s alcoholism, mental-status examinations, daily activities, and psychological test results. Among other things, the court concluded that the administrative law judge improperly separated the effects of alcoholism during the first stage of the disability analysis, relied on some evidence from before M.D.’s alleged disability onset date, and did not explain how relatively normal findings during brief appointments contradicted Dr. Guss’s opinions about anxiety, leaving home, completing tasks, and living independently.

The court also held that the administrative law judge failed to consider all required factors when evaluating Dr. Glassmire’s opinion. The judge did not address, for example, that Dr. Glassmire had not examined M.D. or discuss his specialization. On remand, the administrative law judge must reevaluate Dr. Glassmire’s entire opinion and its consistency with the medical evidence.

Symptom testimony and lay testimony

The court held that the administrative law judge did not give specific, clear, and convincing reasons for rejecting M.D.’s testimony about her symptoms. The court found that the cited improvement during sobriety, mental-status examinations, and daily activities did not adequately account for evidence of continuing symptoms during sobriety, the episodic nature of bipolar disorder, or the limited information about activities such as reading, shopping, attending Alcoholics Anonymous meetings, going to movies, and bowling.

D.D.’s testimony described M.D.’s depression, anxiety, post-traumatic stress disorder, poor concentration, and self-harming behavior. Because the reasons given for rejecting M.D.’s testimony were insufficient, the court held that those reasons also could not support rejecting D.D.’s testimony. The court further found that the administrative law judge had not provided sufficient reasons specific to D.D. for discounting her testimony.

Remand and disposition

The court declined to order an immediate payment of benefits. It concluded that the record was not fully developed, including because it remained unclear whether Dr. Guss had accounted for M.D.’s alcohol use when evaluating her mental functioning and because additional regulatory factors needed to be considered. The court stated that errors in evaluating evidence generally call for further administrative proceedings rather than an automatic award of benefits.

Judge Lisa J. Cisneros granted Plaintiff’s Motion for Summary Judgment, denied Defendant’s Cross-Motion for Summary Judgment, and remanded the matter for further proceedings consistent with the order.