Elvira Garcia v. Commissioner of Social Security

Background

Elvira Alejandre Ponce Garcia sought judicial review under 42 U.S.C. § 405(g) of the Commissioner’s final decision denying her applications for Title II and Title XVI benefits. She alleged disability beginning June 19, 2014, based mainly on back pain and also discussed depression and other medical conditions. After the Social Security Administration denied her applications initially and on reconsideration, an administrative law judge held a hearing and issued an unfavorable decision on March 9, 2017. The Appeals Council denied review.

The administrative law judge found that Garcia had a medically determinable impairment involving lumbar degenerative disc disease but concluded that it was not severe because it did not significantly limit her ability to perform basic work activities for at least twelve consecutive months. The judge also found that the other alleged conditions were not sufficiently supported. In evaluating Garcia’s symptoms, the judge stated that her reports about the intensity, persistence, and limiting effects of her symptoms were not entirely consistent with the medical and other evidence. The judge relied on medical findings, reports that her pain improved when she was active, her physical-therapy noncompliance, and medical opinions that did not support disabling limitations.

Parties’ Arguments

Garcia argued that the administrative law judge improperly rejected medical evidence and substituted a personal opinion for the opinions of medical professionals. She also argued that the judge failed to adequately explain why he rejected her testimony about her symptoms. The Commissioner defended the administrative law judge’s decision.

Court’s Analysis

The court rejected Garcia’s challenge to the treatment of the medical evidence. It found that the administrative law judge adequately explained why he did not treat statements from treating physician Will Sheldon, M.D., as establishing a severe impairment. The judge relied on Sheldon’s earlier statements expressing skepticism about the extent of Garcia’s disability, the lack of a stated duration for Sheldon’s later opinion that Garcia could not work, and the lack of evidence showing a worsening condition. The court also found that the judge adequately explained why he rejected the state agency consultants’ opinions that Garcia had a severe impairment.

The court likewise concluded that opinions from David Carey, M.D., and occupational therapist Joseph Sinay did not undermine the administrative law judge’s decision. Those opinions were prepared after the March 2017 decision and were submitted to the Appeals Council. The court stated that the opinions did not negate the unfavorable decision because they were based on evaluations occurring after the administrative law judge’s decision.

The court, however, found error in the evaluation of Garcia’s testimony. When an administrative law judge finds that a claimant has produced objective evidence of an impairment that could cause the alleged symptoms, and there is no evidence of malingering, the judge must give specific, clear, and convincing reasons for rejecting the claimant’s testimony about symptom severity. Here, the administrative law judge made a general statement that Garcia’s symptom statements were not entirely consistent with the record but did not identify which statements were rejected or connect particular statements to specific medical findings or opinions. The court explained that summarizing the medical evidence is not the same as giving specific reasons for discrediting testimony.

Disposition

The court held that the error required remand so the administrative law judge could determine the extent to which Garcia’s pain and related symptoms affected her disability claim and resolve factual conflicts in the record. The court granted Garcia’s motion for summary judgment, denied the Commissioner’s cross-motion for summary judgment, and remanded the case for further proceedings consistent with the opinion. The court did not order payment of benefits.