Simms v. Commissioner of Social Security

Background

Lionell Simms sought supplemental security income under Title XVI of the Social Security Act. He alleged disability beginning July 1, 2010, based on a combination of mental and physical impairments, including strokes, poor vision, memory loss, spinal and left-arm arthritis, an organic mental disorder, an affective disorder, and substance addiction disorder. The Social Security Administration denied his application initially and on reconsideration. After a hearing, Administrative Law Judge Evangelina Hernandez found that Simms was not disabled. The Appeals Council declined review, making the administrative law judge’s decision the Commissioner’s final decision.

The administrative law judge found severe impairments of depression, lumbar degenerative disc disease, and alcohol abuse. She determined that Simms could perform medium work with restrictions to simple, routine, repetitive, and low-stress tasks, including only occasional decision-making and changes in the work setting. Because he had no past relevant work, the judge relied on vocational-expert testimony to find that he could perform jobs such as laundry worker, store laborer, and dishwasher.

Medical-opinion evidence

The court held that the administrative law judge failed to provide specific and legitimate reasons supported by substantial evidence for discounting the opinions of examining psychologist Dr. Lesleigh Franklin and treating physician Dr. Farrell Barnett, while giving significant weight to the opinions of consultative examiners Dr. Spivey and Dr. Farah Rana.

Regarding Dr. Franklin, the administrative law judge said her opinion was inconsistent with the overall record, relied heavily on Simms’s subjective complaints, and was vague because it referred to impairment in occupational functioning. The court found those explanations inadequate. The administrative law judge did not identify the conflicting evidence or explain why it contradicted Dr. Franklin’s opinion. The record also showed that Dr. Franklin administered multiple psychological and neuropsychological tests, which the administrative law judge did not discuss. The court further found that the reference to occupational functioning was not vague because that is one of the areas measured by the Global Assessment of Functioning scale.

The court also found that the administrative law judge failed to account for the passage of time between Dr. Spivey’s earlier examination and Dr. Franklin’s later examination. In addition, the reasons favoring Dr. Spivey—that she personally examined Simms and had relevant expertise—also applied to Dr. Franklin.

Regarding Dr. Barnett, the administrative law judge discounted his opinion because the limitations were restrictive, treatment had been conservative, objective findings showed mostly mild degenerative disc disease, other medical opinions did not support it, and it appeared to rely on Simms’s subjective complaints. The court found these reasons unsupported or inadequately explained. Dr. Barnett had treated Simms for several years, and treatment records documented repeated reports of severe back pain, referrals for physical therapy and a back specialist, and imaging findings. The court also noted that there was no authority making a checkbox medical form inherently less reliable. Dr. Rana’s opinion, by contrast, was based on review of only two older medical records, and the administrative law judge did not identify the portions of the record that supposedly supported Dr. Rana’s conclusions.

Other issues

Simms argued that the administrative law judge failed to consider whether posttraumatic stress disorder, neurocognitive disorder, anemia, asthma, hyperlipidemia, and gout were severe impairments at the second step of the disability analysis and whether they met or equaled a listed impairment at the third step. Because the court found that the medical evidence had to be reconsidered, it declined to decide those arguments and directed the administrative law judge to address them as appropriate on remand.

The court found that some reasons supporting the adverse evaluation of Simms’s symptom testimony were inadequate. General statements that his symptoms were not fully supported by the record and that medication managed his symptoms did not identify the testimony being rejected or the evidence supporting that conclusion. However, the court found that the administrative law judge could consider Simms’s limited work history and her observations that he walked without difficulty at the hearing and did not bring his cane. The court did not reach Simms’s additional arguments about the residual functional capacity because the medical-evidence error independently required further proceedings.

Ruling and disposition

The court declined to order immediate payment of benefits because the record was not fully developed and unresolved issues remained. It granted Simms’s motion for summary judgment, denied the Commissioner’s cross-motion for summary judgment, and remanded the case for further proceedings consistent with the order. Judge Jacquelyn Corley’s order disposed of Docket Nos. 19 and 27.