Lanh H. v. Kijakazi

Background

Lanh H. sought judicial review of an administrative law judge’s decision denying his application for disability benefits under Title II of the Social Security Act. The Social Security Administration’s Appeals Council declined to review that decision, making it the agency’s final decision for purposes of district-court review. Both sides moved for summary judgment, asking the court to decide the case based on the administrative record.

The record described depression, anxiety, sleep apnea, cognitive problems, and reported seizures or shaking spells. Lanh H. said that fatigue, poor concentration, memory problems, sleep difficulties, and seizures prevented him from working. Dr. Aparna Dixit found moderate cognitive deficits and a marked limitation in maintaining pace and persistence over two-hour periods. Dr. Barry Mann stated that sleep apnea, depression, and medications contributed to fatigue and impaired concentration and estimated that Lanh H. would miss four workdays per month because of seizures.

The administrative law judge found that Lanh H. had not performed substantial gainful activity during the relevant period and had severe depression, anxiety, sleep apnea, and seizure disorder. The judge found no qualifying listed impairment and determined that Lanh H. could perform medium work with restrictions, including simple instructions, limited interaction with others, limited exposure to hazards, no commercial driving, no climbing, and no strict production-rate work. The judge concluded that he could not perform his past work but could work as a dishwasher, food service worker, or stock checker.

Court’s Analysis

The court reviewed whether the administrative law judge’s decision was supported by substantial evidence, meaning relevant evidence that a reasonable person could accept as adequate. The court found that the reasons given for rejecting Lanh H.’s testimony about fatigue and mental limitations were not supported by substantial evidence.

First, the court found that the administrative law judge improperly relied on mostly normal mental-status examinations without accounting for abnormal findings. The court noted that Lanh H.’s scores on some brief examinations declined over time, that Dr. Dixit’s longer memory testing showed significant problems, and that Dr. Griffin diagnosed memory dysfunction. The court also found that a normal electroencephalogram did not, by itself, contradict Lanh H.’s testimony because the test report stated that a normal result did not rule out a seizure disorder.

Second, the court rejected the characterization of Lanh H.’s treatment as conservative. The record showed that he took several medications and regularly saw a neurologist and psychiatrist. The court also explained that psychotherapy and counseling are customary treatments for anxiety and depression, not treatment options showing that those conditions are necessarily mild. The court found that Lanh H.’s difficulty finding a therapist he trusted could have been related to his anxiety or paranoia and should have been considered.

Third, the court found that Lanh H.’s daily activities did not substantially contradict his testimony or show that he spent a substantial part of his day performing functions transferable to a workplace. The activities cited included shopping, walking with others, and limited household chores, but the record also showed that he struggled with those activities and needed encouragement. Fourth, the court found that receiving unemployment benefits did not support rejecting his testimony because the record did not establish what he had certified to the state agency when receiving those benefits.

The court also found that the administrative law judge improperly discounted Dr. Dixit’s marked-limitation assessment. The judge relied on state-agency findings and the supposed conservative nature of Lanh H.’s treatment, but the court found those reasons inadequately supported and insufficiently explained.

As to Dr. Mann, the court agreed that his conclusory statements about whether Lanh H. could work were not persuasive under the cited regulation. But the court found that the administrative law judge lacked substantial evidence for rejecting Dr. Mann’s opinions about concentration and the need to miss more than four workdays per month. The court also found no genuine inconsistency between Dr. Mann’s opinions and Dr. Dixit’s statement that Lanh H. could remember and follow simple instructions; the ability to follow simple instructions did not establish an ability to concentrate on a task for an extended period.

Disposition and Remand Instructions

The court granted Lanh H.’s motion for summary judgment and denied the government’s cross-motion for summary judgment. It remanded the case for further proceedings.

On remand, the administrative law judge must credit as true Lanh H.’s subjective complaints of fatigue and Dr. Dixit’s assessment of a marked limitation in maintaining pace and persistence for two hours. The judge must reevaluate Lanh H.’s testimony about other symptoms and reconsider Dr. Mann’s findings in light of the court’s guidance.

The judge must also develop the record concerning paranoia, fictitious memory, and auditory hallucinations, including possible bipolar disorder or schizophrenia that had not been listed as medically determinable impairments at the second step of the disability analysis. The judge should reconsider the step-three assessment in light of the court’s analysis of Lanh H.’s treatment and the state-agency opinion. The court also stated that the judge may consider obtaining testimony from Lanh H.’s wife about the reported seizure spells. The order did not itself award disability benefits.