Jalissa P. v. O'Malley

Background

Jalissa P. sued under 42 U.S.C. § 405(g) for review of the Commissioner of Social Security’s final decision denying her Supplemental Security Income claim. She moved for summary judgment, and the Commissioner cross-moved for summary judgment. The opinion’s conclusion states that the court reversed the Commissioner’s decision and remanded the action for immediate payment of benefits.

Jalissa P. alleged disability based on depression, post-traumatic stress disorder, a dislocated left knee, and nerve damage in two fingers. The record described a history of severe abuse, mental-health symptoms, suicidal behavior, and substantial drug and alcohol use. The administrative law judge found that, including substance use, Jalissa P. met the requirements of Listing 12.04 for depressive, bipolar, and related disorders. The judge then assessed whether she would remain disabled if she stopped using drugs and alcohol. The judge found that she would not meet the listing without substance use, assigned her a residual functional capacity with several nonexertional restrictions, and concluded that she could perform jobs such as hand packager, floor waxer, and industrial cleaner. The judge therefore found her substance-use disorder material to the disability determination and found her not disabled.

Medical Opinions

The court held that the administrative law judge failed to properly evaluate the medical opinions under the regulations governing claims filed after March 27, 2017. Those regulations require the agency to explain how it considered the supportability and consistency of medical opinions. Supportability concerns whether a source explains an opinion with relevant objective medical evidence; consistency concerns whether the opinion agrees with evidence from other medical and nonmedical sources.

The court found that the administrative law judge gave only a conclusory explanation for rejecting the opinions of Drs. Corrigan, Whitaker, and Kohlstrom during periods of sobriety. The judge did not adequately address supportability and did not separately address the consistency of Drs. Whitaker’s and Kohlstrom’s opinions. The judge also discounted Dr. Corrigan’s opinion largely because her intelligence testing produced a lower result than other estimates. The court held that this disagreement did not constitute substantial evidence showing that Dr. Corrigan’s opinion was entirely wrong, particularly because she had conducted formal testing and other evidence supported her findings.

The court also found errors in the treatment of Chloe Gendreau’s assessment. Although the administrative law judge did not identify the weight given to that assessment, he relied heavily on it in finding substance use material. The court stated that the judge incorrectly referred to Gendreau as a doctor and drew conclusions about Jalissa P.’s ability to interact with others, remember information, adapt, and concentrate from statements in the assessment that did not support those conclusions. The court further found that the chronology of the record did not support crediting certain opinions only during substance-use periods because the relevant examinations and treatment occurred outside the period the judge identified as active substance use.

Symptom Testimony

The court held that the administrative law judge also failed to provide specific, clear, and convincing reasons supported by substantial evidence for rejecting Jalissa P.’s testimony about the severity and effects of her symptoms. The judge relied heavily on two normal mental-status observations made in August and September 2021 and on the absence of mental-health treatment after September 2021. The court found that relying on those limited observations while overlooking a later, more comprehensive examination and other evidence was selective use of the record.

The court also found that the lack of recent treatment was not a valid reason on this record to reject the testimony. Multiple providers had documented Jalissa P.’s difficulty keeping appointments and following through with treatment, including difficulties connected to depression, anxiety, low motivation, and feeling overwhelmed. Finally, the court found that the administrative law judge misstated Jalissa P.’s testimony about her last drug use. Although she initially said “probably eight years ago,” she later clarified that she last used street drugs in 2021 or late 2020 and continued to use marijuana every other day to curb cravings.

The court did not reach Jalissa P.’s remaining arguments because the errors in evaluating the medical opinions and symptom testimony affected the rest of the disability decision. The court found those errors were not harmless.

Remedy and Disposition

The court applied the standard for ordering an immediate award of benefits rather than sending the case back for more administrative proceedings. It found that the administrative law judge had failed to give legally sufficient reasons for rejecting medical opinions and symptom testimony, that no unresolved issues required further development, and that additional administrative proceedings would not be useful.

The court credited the rejected evidence as true for purposes of determining disability and found no serious doubt in the record that Jalissa P. was disabled. It noted that Dr. Kohlstrom found marked or extreme limitations in several areas and that Dr. Corrigan found marked limitations in multiple areas, including interaction with others, concentration, persistence, and adaptation. The court concluded that crediting either opinion would satisfy the functional requirements of Listing 12.04.

The court therefore REVERSED the Commissioner’s decision and REMANDED the case pursuant to sentence four of 42 U.S.C. § 405(g) for immediate payment of benefits.