G.N. v. Kijakazi

Background

G.N. sought review under 42 U.S.C. § 405(g) of the Commissioner of Social Security’s final decision denying her application for supplemental security income. She alleged disability based on spina bifida and related conditions. After a hearing, Administrative Law Judge Serena Hong found that G.N. had severe impairments including spina bifida, shunted hydrocephalus, neurogenic bladder and bowel, and foot deformities. The judge determined that G.N. could perform sedentary work with several restrictions and could perform jobs such as hand packager, final assembler, or order clerk. The judge therefore found G.N. not disabled.

In the district court, G.N. challenged the assessment of her residual functional capacity—the most she could still do despite her impairments—and the evaluation of her testimony and medical opinions. The parties filed documents labeled cross-motions for summary judgment, but the court treated them as opening and response briefs under the Social Security review procedure.

Symptom Testimony

The court held that the administrative law judge did not provide the specific, clear, and convincing reasons required to reject G.N.’s testimony about the severity and effects of her symptoms. The judge relied on records showing that physicians encouraged exercise and on G.N.’s reports of bicycling, attending college, doing well academically, and planning to become a dentist.

The court found that these reasons were not adequately supported. Encouragement to exercise did not show that G.N. could exercise for periods inconsistent with her testimony, and other evidence indicated that she had not engaged in some recommended activities. The judge also failed to discuss that G.N. bicycled with her mother in case she needed help with catheterization, received school accommodations, and relied on her mother for assistance. The court concluded that the written decision ignored or mischaracterized important parts of G.N.’s testimony and required remand on this issue.

Medical Opinions

The court also found errors in the evaluation of three medical opinions.

Dr. Robert Tang, an examining internist, opined that G.N. needed bathroom breaks, bilateral ankle-foot orthoses for walking, and absolute lumbar-spine protection, among other limitations. The administrative law judge did not address Dr. Tang’s opinion about bathroom breaks even though the residual functional capacity assessment omitted that limitation. The court held that the omission affected the residual functional capacity finding and the questions posed to the vocational expert, making the error harmful. The court also held that the judge failed to explain the required supportability analysis for Dr. Tang’s opinion about lumbar-spine protection.

Dr. H. Jone, a non-examining state-agency physician, restricted G.N. to lifting and carrying less than ten pounds and imposed other limitations. The administrative law judge found those lifting restrictions only partially persuasive because they were inconsistent with G.N.’s activities, treatment record, and recommendations for exercise. The court held that the judge failed to evaluate whether those restrictions were supported by the objective medical evidence, as required by the applicable regulations.

Dr. Lisa Leavitt, a pediatrician who had treated G.N. for spina bifida and other conditions, wrote that G.N.’s spina bifida was chronic, required lifelong treatment, and would never be improved or cured. The administrative law judge did not mention or evaluate that opinion. The court held that failing to consider the opinion was clear legal error.

Disposition

The court reversed the Commissioner’s final decision and remanded the case to the Commissioner for further administrative proceedings consistent with the order. The court also awarded G.N. costs under Federal Rule of Civil Procedure 54(d)(1).