Grzegorek v. Berryhill

Background

Aldona Grzegorek challenged a Social Security Administration decision denying her application for disability benefits under Title XVI of the Social Security Act. The parties filed cross-motions for summary judgment, and the court remanded the case to the Social Security Administration for further proceedings.

Grzegorek applied for benefits based on narcolepsy, depression, and anxiety. The administrative law judge (ALJ) found that she had several physical and mental conditions, including circadian rhythm disorder, hypersomnolence, depression, anxiety, attention deficit/hyperactivity disorder, and obesity. The ALJ nevertheless concluded that these conditions did not significantly limit her ability to perform basic work activities and found that she was not disabled.

Court’s Analysis

The court reviewed the denial under the rule that an ALJ’s decision may be disturbed when it lacks substantial evidence—relevant evidence that adequately supports the decision—or rests on a harmful legal error. The court focused on the ALJ’s decision at step two of the five-step disability analysis. At that step, an ALJ determines whether a claimant’s impairments, alone or together, significantly limit basic work activities. The court explained that this is a limited screening step and that a claim should be rejected there only when the medical evidence clearly establishes that the claimant does not have a severe impairment or combination of impairments.

The court found that the ALJ did not provide sufficiently specific reasons supported by substantial evidence for discounting the findings of Grzegorek’s treating physicians concerning narcolepsy and depression. For example, the ALJ gave little weight to sleep specialist Dr. Sydney Choslovsky’s opinion that Grzegorek had physical limitations and recurrent daytime sleep attacks that interfered with routine workplace tasks. The court found that the ALJ inaccurately characterized Grzegorek’s testimony as saying that she had no physical limitations. Although she testified that she had no physical limitations concerning movement, she also testified that exhaustion, fatigue, lack of energy and mental alertness, and an inability to stay awake prevented her from working even part time.

The court also found that the ALJ overstated the effectiveness of treatment for Grzegorek’s sleep disorder. The record included sleep studies confirming narcolepsy and hypersomnolence, reports that she napped during the day, and medical opinions that she would miss work several days per month. The court noted that medication reduced some naps but did not consistently control the condition, and that Grzegorek continued to need daytime naps.

The court found similar problems in the ALJ’s treatment of Dr. Khanh Tran’s opinions. Although Dr. Tran described Grzegorek as stable overall and gave her a good prognosis in some records, he also documented extreme morning weakness, medication that was not working, good and bad days, and likely absences from work. The court concluded that the ALJ improperly selected isolated signs of improvement while failing to address the continuing limitations.

The court further found that the ALJ did not adequately explain the weight given to consulting physician Dr. Nayyar Massod’s opinion. Dr. Massod found no physical limitations while acknowledging that Grzegorek’s narcolepsy and sleep disorders had progressively worsened. Because the ALJ’s explanation relied substantially on the inaccurate description of Grzegorek’s testimony, it did not supply the specific and legitimate reasons required to reject the treating physicians’ opinions.

The court also rejected the ALJ’s treatment of Dr. Choslovsky’s opinion that Grzegorek could not perform her past work or other work. The court stated that physicians may give opinions about the ultimate disability question—the claimant’s ability to work—and that the ALJ could not reject such an opinion using boilerplate language without a substantive explanation.

Finally, the court found that the ALJ improperly gave little weight to the opinions of treating psychiatrists Dr. William Sastry and Dr. Don Mordecai and examining psychologist Dr. Ilene Morrison. Those providers found that Grzegorek was not significantly cognitively impaired but that depression and other mental impairments severely limited her ability to work without interruption. The court found that the ALJ did not provide specific, well-supported reasons for discounting those opinions, and that a different opinion from a nonexamining state consultant, by itself, was not substantial evidence justifying rejection of the treating and examining providers’ opinions.

Disposition

The court held that the ALJ’s decision denying benefits could not stand. It remanded the case to the Social Security Administration for further consideration of Grzegorek’s application consistent with the order. Judge James Donato signed the order on February 10, 2020.