Julia A. v. Commissioner of Social Security

Background

Carmen Julia A. applied for Disability Insurance Benefits in September 2021, alleging that she became disabled on April 2, 2020. The Social Security Administration denied the application initially and on reconsideration. After a hearing, Administrative Law Judge Matthew Levin denied the claim on June 29, 2023. The Appeals Council denied review, making the administrative law judge’s decision the Commissioner’s final decision.

The administrative law judge found that Carmen Julia A. had severe degenerative disc disease of the cervical spine but did not have an impairment that met or medically equaled a listed impairment. He found that she could perform light work with limitations involving climbing, balancing, stooping, kneeling, crouching, and crawling. He then concluded that she could perform her past relevant work as a counter attendant and was not disabled during the relevant period.

Carmen Julia A., represented by counsel, filed this action seeking judicial review. She moved for judgment on the pleadings, meaning she asked the court to decide the case based on the administrative record and the parties’ written submissions.

Issues and Analysis

Carmen Julia A. raised two principal arguments. First, she argued that her work as a counter attendant should not have been treated as past relevant work because she had not performed it within five years before the administrative law judge’s decision. The court rejected that argument. When the administrative law judge issued the decision in June 2023, the applicable regulation defined past relevant work as work performed within the previous 15 years, if it was substantial gainful activity and lasted long enough for the claimant to learn it. Carmen Julia A. did not dispute that she had worked as a counter attendant during that 15-year period. The court also noted that the Commissioner later reduced the lookback period to five years, but courts had concluded that the change was not retroactive and that judicial review should use the regulation in effect when the administrative law judge decided the claim.

Second, Carmen Julia A. argued that the residual functional capacity determination was not supported by substantial evidence and conflicted with the opinion of Dr. Laiping Xie. Residual functional capacity is the claimant’s maximum ability to perform sustained work activities in an ordinary work setting. Dr. Xie diagnosed neck and back pain, knee arthritis, leukemia, and migraine headaches. He found moderate limitations in several activities and stated that the headaches might interrupt her work schedule.

The court upheld the administrative law judge’s assessment of Carmen Julia A.’s exertional ability to perform a reduced range of light work. The court relied on the opinions of two state-agency reviewing physicians, treatment notes showing findings such as normal gait and full range of motion, and evidence that Carmen Julia A. could perform household chores, use public transportation, and shop. The court stated that this evidence supported the exertional portion of the residual functional capacity determination.

The court nevertheless found a problem with the treatment of Carmen Julia A.’s headaches. The administrative law judge discounted Dr. Xie’s opinion about possible schedule interruptions, reasoning that Carmen Julia A. did not consistently report headaches and had obtained relief from Botox injections. The court found that the record did not support that characterization. Carmen Julia A. had reported that the Botox helped but that severe headaches returned as its effect faded. She described headaches lasting up to a week, with pain rated between 5 and 7 out of 10, and stated in a function report that she could not perform activities and had to lie down when experiencing a headache. The administrative law judge did not address this contrary evidence.

Disposition

The court concluded that the administrative law judge had not properly considered the effect of Carmen Julia A.’s headaches on her ability to perform basic work activities on a sustained basis. It therefore found that remand for further administrative proceedings was required.

The court granted Carmen Julia A.’s Motion for Judgment on the Pleadings, remanded the matter for further administrative proceedings consistent with the decision, directed the Clerk to enter final judgment in her favor, and directed the Clerk to close the file.