Aleksey V. P. v. O'Malley

Background

Aleksey V. P. sought child disability benefits based on an alleged mental-health disability that began before he turned 22. The Social Security Administration had found him disabled as an adult and awarded disability benefits, but it denied his claim for child benefits.

The plaintiff filed an application on October 4, 2019, alleging disability beginning December 15, 2002. The claim was denied initially and on reconsideration. An administrative law judge dismissed the application on res judicata grounds, meaning based on the effect of an earlier decision. The Appeals Council later vacated that dismissal because it found res judicata did not apply and sent the matter back for another hearing and consideration of the evidence.

The plaintiff could not attend the later hearings because of his institutionalization, so his father appeared on his behalf. On May 3, 2023, the administrative law judge found that the plaintiff had not provided evidence showing disability before July 15, 2006, the date he turned 22. The Appeals Council denied review after considering medical evidence from Santa Clara Valley Medical Center.

The parties’ arguments

The plaintiff argued that the administrative law judge had failed to consider evidence of psychiatric treatment in 2006, when he was 21. He asked the court to send the case back so the administrative law judge could consider additional medical records submitted to the Appeals Council.

The additional evidence included records from a May 8, 2006 emergency psychiatric-services visit, a June 10, 2006 emergency psychiatric-services visit, and a November 14, 2006 consultation or referral. The Commissioner argued that the records would not change the result because they reflected normal findings.

Court’s analysis

When the Appeals Council considers new evidence in deciding whether to review an administrative law judge’s decision, that evidence becomes part of the administrative record. The district court must consider it when deciding whether the agency’s decision was supported by substantial evidence, meaning enough relevant evidence to support the decision, and whether the agency made a legal error.

The court concluded that the new evidence undermined the administrative law judge’s decision. The administrative law judge had repeatedly emphasized the limited evidence of the plaintiff’s mental health before age 22 and had relied on the absence of complete records from 2006. The hearings had previously been continued so the agency could try to obtain those records.

The court found the Commissioner’s characterization of the records as showing normal findings unpersuasive. Although portions of the records were difficult to read, the court stated that the May 8 notes appeared to indicate that the plaintiff met criteria for suicide risk based on depression and that he was diagnosed with major depression. The June 10 notes appeared to reflect, at least in part, a medication follow-up for a Celexa prescription, and the November 14 form appeared to request a psychiatry referral.

The court also noted that the Appeals Council’s treatment of the evidence was not itself under review because the court lacked jurisdiction to review the Appeals Council’s decision denying review. The court instead considered the evidence as part of the record in evaluating the final agency decision.

Disposition

The court held that substantial evidence did not support the finding that Aleksey V. P. was not disabled during the period at issue. Judge Jacqueline Scott Corley vacated the administrative law judge’s decision and remanded the case for further proceedings consistent with the order. The order disposed of Docket Nos. 15 and 17. It did not award benefits or determine that the plaintiff was entitled to child disability benefits.