Raymond D. v. O'Malley

Background

Raymond D. applied for disability benefits under Title XVI of the Social Security Act in March 2017. After an initial denial, reconsideration denial, and an unfavorable decision by an administrative law judge (ALJ), the case went to federal court. In an earlier round of the case, the court remanded for further proceedings. The ALJ then held three additional hearings and again found that Raymond D. was not disabled.

The ALJ found severe impairments including bipolar II disorder, depressive disorder, generalized anxiety disorder, attention deficit hyperactivity disorder, amphetamine abuse in early remission, and polysubstance dependence. The ALJ determined that Raymond D. could perform work at all exertional levels with limits on routine tasks, workplace changes, fast-paced production work, social interaction, and access to illegal substances. Relying on vocational-expert testimony, the ALJ identified hospital cleaner, industrial cleaner, and hand packager as jobs existing in the economy.

Raymond D. moved for summary judgment seeking reversal of the Commissioner's decision. The Commissioner cross-moved for summary judgment seeking affirmance.

Medical-opinion evidence

The ALJ gave great weight to the opinion of Michael Lace, PsyD, a non-examining medical expert, and partial weight to the opinion of Elizabeth Walser, MSW, PsyD, an examining psychologist. Walser evaluated Raymond D. while he was incarcerated and found extreme or marked limitations in several work-related abilities, including responding to supervisors, maintaining attention, interacting with others, handling changes and work stress, completing a normal workday, and maintaining attendance.

Because Walser was an examining physician and her opinion conflicted with Lace's opinion, the court held that the ALJ needed specific and legitimate reasons supported by substantial evidence to discount Walser's opinion. The court found that the ALJ did not meet that standard. In particular, the ALJ relied on Raymond D.'s statements that he had a fair ability to interact with authority figures and a good ability to get along with other inmates, but did not account for evidence that he had repeatedly been placed in administrative segregation and preferred solitary confinement. The court also found that prison interactions did not necessarily show how Raymond D. would function in a regular work setting.

The court further found that Raymond D.'s statement that he had never been fired or had problems with an employer said little about his current ability to work because he had not worked for many years. The ALJ also referred generally to treatment notes without identifying specific notes that contradicted Walser's findings. The court rejected the ALJ's characterization of Walser's opinion as speculative based on her use of the word “likely,” and found that Walser had adequately explained her findings through her examination, testing, and review of Raymond D.'s history.

The court also found error in the ALJ's treatment of the Amen Attention index as based on subjective allegations. Walser had conducted a clinical interview, a mental-status examination, and other tests, and the Amen checklist was only one part of her evaluation. The court agreed that the ALJ could find one particular opinion about processing pace less persuasive because formal processing-speed testing was not completed, but held that the ALJ did not explain why the lack of that testing undermined Walser's other opinions.

Finally, the court held that Lace's non-examining opinion could not, by itself, provide substantial evidence for rejecting Walser's conflicting opinion. The ALJ had not identified the evidence supporting Lace's opinion and contradicting Walser's opinion. The court concluded that the ALJ erred by giving Walser's opinion only partial weight and Lace's opinion great weight.

Raymond D.'s symptom testimony

The ALJ found that Raymond D.'s impairments could cause some of his symptoms but that his statements about their intensity and limiting effects were not entirely consistent with the record. Because the ALJ did not find that Raymond D. was pretending to have symptoms, the ALJ needed specific, clear, and convincing reasons for rejecting his testimony.

The court found that the ALJ generally referred to allegations that Raymond D. could not perform any work without identifying which statements were rejected or explaining what evidence undermined them. The ALJ did adequately explain why Raymond D.'s 2017 statement that he had difficulty maintaining employment because of conflicts with supervisors should not be credited, because that statement conflicted with his 2024 testimony that he had never been fired or had problems with an employer. But the court found that the ALJ did not satisfy the required standard for the rest of Raymond D.'s statements and testimony.

Other issues and remedy

Raymond D. also challenged the ALJ's finding that his impairments did not meet or equal a listed impairment and the ALJ's residual functional capacity finding. The court found that those issues were premature because the reasoning for them depended substantially on the ALJ's treatment of the medical opinions and Raymond D.'s testimony.

Raymond D. requested a remand directing an award of benefits. The court declined to do so because outstanding issues remained. The record might contain evidence contradicting Raymond D.'s testimony and Walser's opinion, and it might contain evidence supporting the ALJ's residual functional capacity finding even after considering Raymond D.'s limitations. Because the record was uncertain and ambiguous, the court held that further administrative proceedings were appropriate.

Disposition

Chief Magistrate Judge Donna M. Ryu granted Raymond D.'s motion for summary judgment, denied the Commissioner's cross-motion, reversed the ALJ's decision, and remanded the case for further administrative proceedings consistent with the order. The court directed the ALJ to reconsider the credibility determination and medical opinions and to determine whether reconsideration of the other issues raised by Raymond D. was necessary.