Laura A.V. v. Bisignano

Background

Laura A.V. sought judicial review under 42 U.S.C. § 405(g) of the Commissioner of Social Security’s final decision denying her application for disability insurance benefits. She alleged disability beginning April 1, 2021, based on myalgic encephalomyelitis and chronic fatigue syndrome. An administrative law judge held hearings, considered testimony from Laura A.V. and a vocational expert, and found that she could perform light work with several restrictions. The administrative law judge concluded that jobs existed in significant numbers that Laura A.V. could perform and found that she was not disabled. The Appeals Council denied review.

Laura A.V. challenged the administrative law judge’s treatment of Dr. Ruby Tam’s medical opinion and the assessment of her residual functional capacity, meaning the most work she could do despite her limitations. The Commissioner argued that the administrative decision should be affirmed.

Medical-Opinion Analysis

Dr. Tam treated Laura A.V. for myalgic encephalomyelitis and chronic fatigue syndrome and provided a medical source statement. Dr. Tam stated that Laura A.V. had substantial limits on sitting, standing, walking, lifting, and working consistently. Dr. Tam also stated that Laura A.V. would need a flexible schedule, would be off task at least 25 percent of a typical workday, and would miss more than four days per month.

The administrative law judge found Dr. Tam’s opinion unpersuasive, stating that it was inconsistent with treatment records and was not supported by those records. Judge Foster ruled that this explanation was inadequate. The administrative law judge cited records without explaining which portions were inconsistent with Dr. Tam’s opinion or how they were inconsistent. Judge Foster also concluded that the administrative law judge’s description of Dr. Tam’s records as brief overlooked the detailed treatment documentation and standardized assessments supporting the opinion. In addition, consistency between Dr. Tam’s opinion and Laura A.V.’s statements was not a reasonable basis for discounting the opinion.

Residual Functional Capacity

The administrative law judge concluded that Laura A.V. could perform light work and sustain a full 40-hour workweek. Judge Foster found that the explanation did not adequately connect the evidence to that conclusion.

The administrative law judge relied on Laura A.V.’s daily activities, part-time work, treatment history, and medical opinions. But Judge Foster determined that the decision did not adequately account for Laura A.V.’s testimony that she performed activities only when rested, worked no more than about 15 hours per week on a flexible schedule, and needed frequent rest. The ability to perform chores or part-time work during limited periods did not, by itself, show an ability to work eight hours per day or 40 hours per week.

Judge Foster also concluded that the medical opinions cited by the administrative law judge did not support the 40-hour-workweek finding. Dr. Matthias Jordan’s opinion stated that Laura A.V. was incapable of sustaining a 40-hour workweek, and Ms. Erika Kuis’s opinion described periods of standing and walking with rest but did not state that Laura A.V. could work eight hours in a day or 40 hours in a week.

Disposition

The court held that the administrative law judge failed to sufficiently explain the rejection of Dr. Tam’s opinion and failed to adequately support the conclusion that Laura A.V. could sustain a 40-hour workweek. The court therefore remanded the matter to the Social Security Administration under sentence four of 42 U.S.C. § 405(g) for further proceedings consistent with the Order.

The Order states that Laura A.V.’s request for relief was granted in part and denied in part, that the Commissioner’s request for relief was denied, and that judgment should be entered accordingly.