Edlin v. Saul

Background

Nathan Edlin sought judicial review of an administrative law judge’s denial of his applications for disability insurance benefits and supplemental security income. The administrative law judge found that Edlin had severe impairments including human immunodeficiency virus, Kaposi’s sarcoma, hepatitis C, and substance abuse, but found that his depression was not severe and did not discuss his posttraumatic stress disorder. The judge concluded that Edlin’s impairments did not meet or equal a listed impairment and that he could perform jobs existing in significant numbers. The Social Security Appeals Council declined review, making the administrative law judge’s decision the Commissioner’s final decision.

Edlin’s medical evidence included persistent Kaposi’s sarcoma lesions on his arms, legs, back, and foot. The record described a painful and bleeding foot lesion that continued to cause problems despite chemotherapy and later required referral for radiation. A consulting psychologist, Caroline Salvador-Moses, diagnosed recurrent severe major depressive disorder and posttraumatic stress disorder. She also reported substantial limitations in Edlin’s ability to perform daily activities and work-related mental tasks. The record stated that Edlin had difficulty with personal care and hygiene and relied on his partner for household chores, shopping, and laundry.

Issues and Analysis

Both parties moved for summary judgment, asking the court to rule based on the administrative record. Edlin argued that the administrative law judge committed legal error at Step Three by failing to properly evaluate Listing 14.11, which addresses disabling manifestations of HIV, and that the residual functional capacity finding was not supported by substantial evidence. The Commissioner argued that Edlin did not meet Listing 14.11 because he did not have pulmonary Kaposi’s sarcoma and did not have the required marked limitations in daily activities, social functioning, or concentration, persistence, and pace.

The court held that the administrative law judge erred by considering only whether Edlin had pulmonary Kaposi’s sarcoma and by evaluating functional limitations arising only from depression. Listing 14.11 also covers repeated HIV manifestations, including non-pulmonary Kaposi’s sarcoma, when they cause the required functional limitations. Because Edlin’s lesions were persistent and affected multiple limbs, the administrative law judge had a duty to develop the record concerning the functional effects of those lesions.

The court also found errors in the evaluation of the mental-health evidence. The administrative law judge gave little weight to Dr. Salvador-Moses’s opinions because Edlin lacked psychiatric treatment and because the judge believed the record showed continued amphetamine use. The court found those reasons insufficient. It also held that the administrative law judge failed to discuss or analyze the posttraumatic stress disorder diagnosis and improperly relied on a nonexamining consultant’s opinion when finding that depression was not severe. The court explained that a nonexamining physician’s opinion, standing alone, does not constitute substantial evidence supporting rejection of an examining psychologist’s opinion.

Disposition

The court GRANTED Plaintiff’s Motion for Summary Judgment and DENIED Defendant’s Motion for Summary Judgment. It REMANDED the case for further proceedings. On remand, the Commissioner was directed to give due consideration to Edlin’s posttraumatic stress disorder diagnosis, properly address the evidence concerning his functional limitations, and either give controlling weight to Dr. Salvador-Moses’s opinions or sufficiently develop the record. The order did not award benefits itself.