Suzanne v. Commissioner of Social Security

Background

Suzanne E. sought judicial review under 42 U.S.C. § 405(g) of the Commissioner of Social Security’s final decision denying her claim for Title II disability insurance benefits. She alleged disability beginning October 1, 2017, based on fibromyalgia, asthma, migraine, obsessive-compulsive disorder, panic disorder with agoraphobia, generalized anxiety disorder, and depressive disorder.

Her application was denied initially and on reconsideration. After a hearing at which Suzanne E. and a vocational expert testified, the administrative law judge (ALJ) issued an unfavorable decision on April 10, 2024, finding that she was not disabled. The Appeals Council denied her request for review. The parties then filed briefs in the district court.

Issue and Legal Standard

The sole issue was whether the ALJ improperly rejected Suzanne E.’s testimony about the severity and effects of her symptoms. Under the Ninth Circuit’s two-step approach, the ALJ first determines whether objective medical evidence shows an impairment that could reasonably produce the alleged symptoms. If that requirement is met and there is no evidence of malingering, the ALJ may reject the testimony only by giving specific, clear, and convincing reasons supported by substantial evidence.

Court’s Analysis

The court identified several errors in the ALJ’s analysis:

1. Failure to clearly apply the two-step test. Although the ALJ referred to the two-step approach, the ALJ did not expressly determine at the first step whether the underlying impairments could reasonably produce the alleged symptoms. The ALJ’s discussion also expressed doubt about the truthfulness of Suzanne E.’s reports, creating uncertainty about whether the ALJ had found malingering. The court held that this ambiguity required remand.

2. Failure to give adequate reasons for rejecting the testimony. The ALJ attributed Suzanne E.’s decision to leave her job partly to hatred of the job rather than medical conditions. The court found that this reasoning did not account for medical-record statements that the job worsened her depression, anxiety, panic attacks, headaches, and migraines. The court also found that the ALJ emphasized portions of records showing improvement while overlooking statements from the same visits describing continuing serious symptoms. This selective treatment of the evidence failed to consider the record as a whole.

3. Insufficient consideration of treatment history. The ALJ relied on inconsistent treatment in discounting testimony about Suzanne E.’s mental impairments and fibromyalgia. The court stated that an ALJ must consider reasons for not pursuing treatment. The record indicated that a behavioral-health referral had been rejected because of insurance restrictions. The court also explained that mental-health symptoms may improve and worsen over time, and that isolated reports of improvement must be considered in context.

The court did not address the ALJ’s findings about Suzanne E.’s daily activities because those findings concerned their inconsistency with reports of musculoskeletal pain and fibromyalgia.

Disposition

The court REVERSED the ALJ’s decision and REMANDED the case for further proceedings consistent with the order. It explained that the appropriate remedy was further agency review because Suzanne E. had not argued or analyzed why the court should instead order an award of benefits. The court directed the ALJ to reconsider the symptom testimony in the context of the full record and to apply the two-step analysis clearly. The order disposed of Docket Nos. 12 and 15.