T. H. v. Commissioner

Background

T. H. sought review under 42 U.S.C. § 405(g) of the Commissioner’s final decision denying Title II disability-insurance benefits. His insured status expired on December 31, 2023, so he had to establish disability between February 20, 2019, his alleged onset date, and December 31, 2023.

The administrative law judge found severe impairments consisting of degenerative disc disease, hip osteoarthritis, and schizophrenia. The administrative law judge found gastrointestinal conditions, including gastroesophageal reflux disease and irritable bowel syndrome, not severe. The administrative law judge assessed a residual functional capacity for medium work with restrictions involving postural activities, simple tasks and decisions, occasional social interaction and workplace changes, and no production-paced work. Based on vocational-expert testimony, the administrative law judge found that T. H. could perform work as a hand packager, hospital cleaner, or cleaner II and was not disabled.

T. H. challenged two parts of that decision. First, he argued that irritable bowel syndrome should have been found severe and that the residual functional capacity should have included limitations related to it. Second, he argued that the administrative law judge lacked adequate reasons for rejecting his testimony that nausea and vomiting were frequent, severe, and prevented work.

Step-Two Finding

The court held that any error in finding irritable bowel syndrome not severe was harmless. Step two is a screening stage; once a claimant has at least one severe impairment and the analysis continues, the administrative law judge must consider the limiting effects of all impairments when assessing the residual functional capacity.

Here, the administrative law judge found three severe impairments and proceeded through all five steps. The administrative law judge also reviewed the irritable-bowel-syndrome and gastroesophageal-reflux-disease treatment history, addressed T. H.’s testimony about nausea and vomiting, applied the symptom-evaluation framework, and evaluated medical opinions concerning related functional limits. The court therefore did not need to decide whether the evidence satisfied the threshold for a severe impairment. The question whether the residual functional capacity needed digestive-symptom limitations depended instead on the challenges to the symptom testimony and the medical opinions.

Symptom Testimony

The court held that the administrative law judge gave a specific, clear, and convincing reason supported by substantial evidence for discounting T. H.’s testimony about nausea and vomiting. T. H. testified that vomiting occurred almost continuously, required several Zofran tablets, took about three days to recover from, and was especially bad in 2023.

The court found that the longitudinal treatment record contradicted the alleged frequency and severity of those symptoms. During the relevant coverage period, providers repeatedly recorded symptom reviews that were negative for nausea and vomiting. In December 2022, T. H. described his irritable bowel syndrome as overall stable on medication. A June 2023 examination noted a history of nausea and vomiting but also that medication controlled the symptoms. In December 2023, shortly before the insured-status period ended, he reported on-and-off abdominal pain and cramping, while the symptom review was again negative for vomiting.

The court rejected arguments that the prescriptions for Reglan and Zofran established the alleged frequency or severity of the symptoms. It also concluded that T. H.’s explanation that he treated episodes at home did not account for the negative symptom reviews during medical visits. The court noted that a chronology in the administrative law judge’s decision was imprecise, but concluded that the discrepancy concerned bowel symptoms rather than the nausea and vomiting at issue.

The court agreed that the administrative law judge’s reliance on activities such as driving, shopping, following a movie, gambling, walking, and dining did not support rejecting the testimony about episodic vomiting. Some cited activities concerned social or cognitive limitations, and some occurred after the date last insured. But the court held that this error was harmless because the treatment-record rationale was legally sufficient and independently supported by substantial evidence.

Disposition

The court held that the adverse symptom finding stood and that the residual functional capacity and step-five finding therefore also stood. Magistrate Judge Laurel Beeler affirmed the Commissioner’s final decision and denied the request for remand. The order resolved ECF Nos. 9 and 10.