T.O. v. Nancy A . Berryhill

Background

T.O. applied for disability benefits on December 18, 2014, alleging that his disability began on October 1, 2014. The application was denied initially and on reconsideration. After a June 20, 2017 hearing, Administrative Law Judge Lisa Lunsford determined that T.O. had not engaged in substantial gainful activity and had three severe impairments: epilepsy, depression, and a neurocognitive disorder.

The administrative law judge found that T.O.’s impairments did not meet the regulatory requirements for automatic disability findings. She assessed a residual functional capacity allowing medium work with restrictions involving workplace hazards, noise, simple tasks, changes in routine, and interactions with the public and coworkers. Based on vocational-expert testimony, she found that T.O. could not return to his past work but could perform other jobs available in the national economy.

The record included evidence of recurrent seizures, including eleven seizures recorded during a two-week video electroencephalogram in March 2015, surgery in October 2015, continuing depression and suicidal thoughts, an involuntary psychiatric hospitalization in September 2016, and neuropsychological testing showing significant memory and cognitive limitations. Consulting psychologist Dr. Paul Martin diagnosed an unspecified neurocognitive disorder and depressive disorder. He assessed moderate limitations in several work-related abilities and a marked limitation in completing a normal workday or workweek without interruptions caused by T.O.’s psychiatric condition.

The Court’s Analysis

The court reviewed the Commissioner’s decision under 42 U.S.C. § 405(g). Under that standard, the court must uphold factual findings supported by substantial evidence, meaning evidence that a reasonable person could accept as adequate, but must set aside a decision that applies incorrect legal standards.

The court held that the administrative law judge improperly rejected Dr. Martin’s opinion. The judge gave partial weight to Dr. Martin’s findings but gave little weight to the marked limitation and one moderate limitation, stating that they were unsupported by the record and that T.O. was not receiving regular mental-health treatment. The court found this explanation conclusory and unsupported because the judge did not identify evidence contradicting Dr. Martin’s opinion and appeared to overlook Dr. Martin’s findings of extremely low functioning in some areas.

The court also held that the lack of regular mental-health treatment could not be used in this record without considering possible reasons for that lack of treatment. The record showed that T.O. had lost insurance near the alleged onset of disability and that insurance did not cover mental-health treatment at Stanford Hospital. The court further noted that depression itself can affect a person’s ability to seek treatment. The administrative law judge had not asked T.O. about these issues at the hearing.

The court separately held that the administrative law judge improperly evaluated T.O.’s symptom testimony. The judge acknowledged that T.O.’s impairments could reasonably produce his symptoms and did not identify malingering, so the judge needed specific, clear, and convincing reasons to reject testimony about symptom severity. The court found that the judge’s reliance on generally normal examinations, lack of treatment, and several alleged inconsistencies did not satisfy that requirement. Among other things, the judge misstated T.O.’s testimony about seizure duration and overlooked medical reports describing approximately monthly seizures before surgery.

Remedy and Disposition

The court declined to apply the Ninth Circuit’s credit-as-true rule, which can require an immediate benefits award when improperly rejected evidence must be accepted and the record leaves no serious doubt about disability. The court found unresolved issues, including the significance of inconsistencies in T.O.’s history, the reasons he did not obtain recommended mental-health treatment, the absence of a treating doctor’s statement addressing the effects of his impairments, and the need for review of the complete record by a medical professional.

The court did not reach T.O.’s arguments concerning his wife’s function report or whether he could perform the jobs identified by the vocational expert. It stated that those issues should be considered on remand.

Chief Magistrate Judge Joseph C. Spero granted T.O.’s motion for summary judgment, denied the Commissioner’s motion for summary judgment, and remanded the case for further administrative proceedings consistent with the order. The opinion did not award benefits.