Derwin L. v. Commissioner of Social Security

Background

Derwin L. applied for Supplemental Security Income benefits in March 2017, alleging disability beginning June 15, 2016. The Commissioner of Social Security denied the application. After several administrative hearings and two remands by the Appeals Council, Administrative Law Judge Elias Feuer issued a January 8, 2024 decision denying benefits. The Appeals Council later declined further review, making that decision the Commissioner’s final decision.

The administrative law judge found that Derwin L. had severe physical and mental impairments, including degenerative disc disease, a residual bullet fragment in the lumbar spine, chronic obstructive pulmonary disease, bipolar disorder, anxiety, and post-traumatic stress disorder. The judge concluded that Derwin L. could perform light work with certain physical, environmental, and stress-related restrictions. The judge also found that he could perform his past work as an auto salesperson and could perform other jobs existing in significant numbers in the national economy.

Derwin L., represented by counsel in this federal case, moved for judgment on the pleadings. The Commissioner opposed the motion and requested judgment on the pleadings as well.

Court’s Analysis

The court reviews a Social Security decision to determine whether substantial evidence supports it and whether the Commissioner used the correct legal standard. Substantial evidence means relevant evidence that a reasonable person could accept as adequate support for a conclusion.

The court held that the administrative law judge did not adequately develop the record concerning Derwin L.’s physical limitations. The judge relied in part on consultative examinations conducted in 2017 and 2019, as well as an older state-agency review. The court noted that the examinations occurred years before the January 2024 decision and that later records described persistent and worsening pain, reduced movement and strength, and significant findings on imaging, including disc narrowing, herniation, bulging, and stenosis. Treating providers also gave opinions that Derwin L. could not work, although the court recognized that statements about whether someone is disabled are issues reserved to the Commissioner and are not, by themselves, persuasive medical opinions about functional capacity.

The court concluded that the administrative law judge should have considered obtaining functional assessments from treating providers, ordering updated consultative examinations, or obtaining testimony from a medical expert who reviewed the complete record. Instead, the judge relied on an assessment of the medical records, imaging, and Derwin L.’s activities without taking those additional steps.

The court found a similar failure concerning mental limitations. The administrative law judge relied on psychiatric evaluations from 2017 and 2019, while later treatment records documented bipolar disorder, post-traumatic stress disorder, severe anxiety, recurring nightmares, mood-regulation problems, and concentration difficulties. The court said the administrative law judge should have sought functional assessments from treating providers and considered updated examinations. The court emphasized that an administrative law judge has a heightened duty to develop the record when a claimant asserts a mental impairment.

The Commissioner argued that Derwin L.’s counsel was responsible for completing the record. The court rejected that argument on these facts because there was no evidence that the administrative law judge followed up with counsel or took independent steps to ensure that the record was complete.

Disposition

Magistrate Judge Gary R. Jones granted Derwin L.’s Motion for Judgment on the Pleadings. The court remanded the matter for further administrative proceedings consistent with the decision and directed the Clerk to enter final judgment in Derwin L.’s favor and close the file. The court did not find that Derwin L. was actually disabled and did not order the calculation or payment of benefits.