A.B. v. O'Malley

Background

A.B. challenged the Commissioner of Social Security’s finding that she was not disabled and therefore was not eligible for disability insurance or supplemental security income benefits. The administrative judge found several severe impairments, including mental impairments, back and foot conditions, and a left index-finger cyst that had been surgically removed in September 2022. The administrative judge found that A.B. could perform light work with additional restrictions and could work as a mail sorter, merchandise marker, or routing clerk.

A.B. testified that her left index finger remained weak, stiff, and difficult to bend after surgery. She said she had to perform tasks such as dressing, washing dishes, and sweeping with one hand, and that she sometimes dropped things. Medical and occupational-therapy records documented pain, swelling, stiffness, and limited movement before and after surgery. The records also showed some improvement, but the final treatment note in the record stated that A.B. was still working toward making a fist and touching her palm with her index finger.

The parties’ arguments

A.B. argued that the administrative judge improperly rejected her testimony about the finger impairment and improperly evaluated medical opinions and other evidence concerning her physical and mental impairments. She also argued that the court should order benefits rather than send the case back for more agency proceedings.

The Commissioner argued that the administrative judge reasonably relied on medical findings, treatment records, reported activities, and evidence of improvement. The Commissioner also argued that the administrative judge properly evaluated the conflicting medical opinions and correctly determined that jobs were available to A.B. under the assessed work restrictions.

Court’s analysis

The court held that the administrative judge erred in evaluating A.B.’s testimony about her finger impairment. The administrative judge accepted that A.B.’s medically determinable impairments could reasonably cause the alleged symptoms. Under the governing standard described by the court, the administrative judge therefore needed to give specific, clear, and convincing reasons for rejecting testimony about the severity and effects of those symptoms.

Instead, the administrative judge stated generally that A.B.’s statements were not fully consistent with the evidence. The court found that the decision did not identify which specific testimony about A.B.’s finger was being rejected. It was unclear whether the administrative judge rejected A.B.’s statements that she needed to perform household tasks one-handed, dropped things, or had been told that her finger might not recover, or whether the administrative judge accepted those statements but found that they did not require additional work restrictions.

The court also found that the evidence cited by the administrative judge did not adequately justify rejecting A.B.’s testimony. The absence of a fracture, degenerative changes, or a neurological explanation did not by itself disprove her reported pain and limited movement. Similarly, some improvement during treatment did not establish a particular level of work capacity or disprove continuing symptoms. The court noted that the administrative judge had not adequately addressed ongoing treatment records showing pain and restricted movement after the evidence of improvement.

The court discussed possible concerns about complex regional pain syndrome, including whether the record warranted consideration of Type I rather than only Type II complex regional pain syndrome. Because the parties had not briefed that issue, however, the court did not rely on it as a basis for reversal.

The court also concluded that the administrative judge’s treatment of the duration of the finger symptoms was inadequate. Although the administrative judge questioned whether newer trigger-finger symptoms would last at least twelve months, the court found that documentation of finger-related pain and limited movement extended for more than a year. The administrative judge also did not identify which limitations from the condition could be disregarded based on the twelve-month requirement.

The court did not decide whether the administrative judge improperly rejected Dr. Rose Lewis’s opinion about occasional fingering. That opinion contained conflicting indications, including a form entry stating that A.B. could finger frequently, so the agency would need to resolve that ambiguity on remand. The court likewise did not decide A.B.’s other challenges concerning standing, walking, or mental impairments because those issues did not require an immediate benefits award.

Disposition

The court held that the error concerning A.B.’s finger-impairment testimony was not harmless because the assessed work capacity included no restriction addressing the reported difficulty using the finger. The court rejected A.B.’s request for an immediate judicial award of benefits because further fact-finding and judgment were required, including determining the specific work restrictions supported by the evidence and resolving conflicting medical and vocational evidence.

Judge Cisneros reversed the Commissioner’s decision and remanded the case for further administrative proceedings consistent with the order. The court denied A.B.’s request for a judicial award of benefits. The clerk was directed to enter judgment in A.B.’s favor and close the case.