Gordon v. O'Malley

Background

Melissa Nicole Gordon applied for Social Security Disability Insurance and Supplemental Security Income benefits, alleging that she became disabled on January 20, 2020. The applications were denied initially and on reconsideration. After a hearing, an administrative law judge found that Gordon had severe impairments including a benign brain tumor, migraine headaches, major depressive disorder, and generalized anxiety disorder, but concluded that she was not disabled. The judge determined that Gordon could perform a restricted range of medium work and could perform several jobs identified by a vocational expert.

After the Social Security Administration’s Appeals Council denied review, Gordon asked the district court to review the decision under 42 U.S.C. § 405(g). Gordon moved for summary judgment, seeking reversal of the administrative decision. The Commissioner cross-moved for summary judgment, seeking affirmance.

Issues and Analysis

The court reviewed whether the administrative law judge’s findings were based on legal error or supported by substantial evidence, meaning relevant evidence that a reasonable person could accept as supporting the conclusion.

Migraine Listing Analysis

Gordon argued that the administrative law judge failed to properly consider whether her migraine disorder medically equaled Listing 11.02. Although migraines are not themselves listed impairments, Social Security Ruling 19-4p explains that a primary headache disorder may be equivalent in severity and duration to the criteria for Listing 11.02 involving dyscognitive seizures.

The court found that the administrative law judge did not consider Listing 11.02 or Social Security Ruling 19-4p in the listing analysis. Later, while discussing Gordon’s credibility and residual functional capacity, the judge applied factors used to determine whether a headache disorder was medically determinable, rather than explicitly considering whether the migraines medically equaled Listing 11.02.

The court also found that the administrative law judge inaccurately described the record. An MRI had evaluated whether Gordon’s migraines were caused by a recurrence of her benign brain tumor, and a neurologist determined that they were likely not caused by such a recurrence. The court further found that the judge improperly relied on Gordon’s failure to try Botox or anticonvulsants even though the record did not show that those treatments had been prescribed or recommended. The court held that the listing analysis lacked an adequate foundation and directed the administrative law judge on remand to follow Social Security Ruling 19-4p when assessing whether Gordon’s condition medically equaled a listing.

Evaluation of Gordon’s Symptom Testimony

The court next considered Gordon’s challenge to the administrative law judge’s evaluation of her testimony about the severity and effects of her symptoms. Because the judge did not find that Gordon was malingering, the judge was required to give specific, clear, and convincing reasons for rejecting her testimony.

The court found that the judge failed to meet that standard. The judge generally stated that the medical records did not support the degree of limitation Gordon alleged, but did not identify specifically which testimony was rejected or explain what evidence undermined it. The court also found that the judge improperly treated the headache-disorder analysis as part of the credibility analysis and relied on the absence of medical evidence corroborating Gordon’s reports.

The court found additional problems with the judge’s treatment of Gordon’s migraine-related records. Notes stating that the migraines were gradually improving and stable on medication did not establish that they were controlled well enough for Gordon to engage in gainful activity. The judge also mischaracterized a March 2022 appointment as a neurological follow-up even though the records identified it as an annual gynecology examination that did not discuss Gordon’s migraines. The court found that the judge speculated about the availability and effectiveness of other treatments and failed to consider evidence that Gordon had sought additional treatment. Finally, the judge identified inconsistencies in Gordon’s statements about marijuana use but did not explain how those inconsistencies related to the frequency, severity, or limiting effects of her impairments.

Medical Opinions

The court found that the improper symptom evaluation likely affected the administrative law judge’s assessment of the medical opinions, particularly the opinions of examining psychologist Katherine Wiebe and treating psychologist Elizabeth Nickels.

The judge had found Wiebe’s opinion unsupported because it was based on Gordon’s allegedly exaggerated assessment of her impairments. The court held that this reasoning was affected by the improper rejection of Gordon’s symptom testimony. The court also found that the judge incorrectly stated that Wiebe lacked access to Gordon’s longitudinal medical history; the record showed that Wiebe had reviewed treatment records from 2019 through 2021.

Regarding Nickels’s opinion that Gordon would miss four or more workdays per month, the judge stated that the opinion lacked an explanation and was unsupported because the record did not show a history of missed appointments. The court found that the judge failed to address explanations Nickels had provided, including Gordon’s depression, history of self-harm, isolation, fatigue, agitation, irritable mood, and chronic migraines. The court directed the administrative law judge to reconsider the medical opinion evidence on remand. The court did not reach Gordon’s arguments concerning the opinions of neurologist Edie Glantz or the state-agency medical consultants R. Dwyer and A. Cepeda.

Disposition

The court granted Gordon’s motion for summary judgment and denied the Commissioner’s cross-motion for summary judgment. The matter was remanded for further proceedings consistent with the opinion. The opinion did not award benefits or decide that Gordon was disabled.