J.M. v. Saul

Background

J.M. applied for Supplemental Security Income under Title XVI of the Social Security Act, alleging disability beginning February 10, 2003. The Social Security Administration denied the application initially and on reconsideration. After a hearing, administrative law judge Kevin Gill denied the application on August 30, 2018. The Appeals Council denied review, making the administrative law judge’s decision the Commissioner’s final decision. J.M. then sought review in the district court under 42 U.S.C. § 405(g).

The administrative law judge found that J.M. had severe depressive, anxiety, personality, post-traumatic stress, substance-use, and osteoarthritis impairments. He concluded that J.M.’s impairments did not meet or equal a listed impairment and assessed a residual functional capacity for medium work with restrictions, including detailed but noncomplex tasks and work in a nonpublic environment. Based on testimony from a vocational expert, the administrative law judge found that J.M. could perform jobs such as cleaner, packager, and laundry worker.

Court’s Analysis

The court reviewed whether the administrative law judge applied the proper legal standards and whether the findings were supported by substantial evidence, meaning relevant evidence that a reasonable person could accept as adequate.

The court held that the administrative law judge did not give specific and legitimate reasons, supported by substantial evidence, for giving only partial weight to Dr. Wiebe’s opinions. The supposed inconsistency in Dr. Wiebe’s findings about social functioning was not apparent because the general category of social functioning covered several different abilities. The court also found that references to depression being in “partial remission” did not show that J.M. was symptom-free and that the administrative law judge had selectively relied on records suggesting improvement while overlooking the broader record. Finally, the administrative law judge did not adequately explain why the record supposedly failed to support Dr. Wiebe’s diagnoses of post-traumatic stress disorder and unspecified personality disorder.

The court also held that the administrative law judge did not provide germane, or appropriately specific, reasons for giving little weight to therapist Jennifer Wachter’s opinions. The finding that mental-status examinations were generally normal mischaracterized the record, which contained multiple examinations showing abnormal findings. The evidence that medication sometimes reduced J.M.’s symptoms did not contradict Wachter’s opinion that significant depression and anxiety continued. The administrative law judge also did not adequately address evidence that difficulty taking medication could itself be related to J.M.’s mental impairments. The court rejected the characterization of Wachter’s questionnaire as conclusory because she gave detailed explanations supported by treatment notes.

The court further held that the administrative law judge did not provide specific, clear, and convincing reasons for discounting J.M.’s testimony about the severity of his symptoms. The administrative law judge improperly relied on selected references to remission and on supposedly routine and conservative treatment. He also relied on a treatment gap in 2017 without asking J.M. why it occurred or addressing evidence that travel, homelessness, difficulty accessing care, and mental-health limitations contributed to the gap.

The court found legal error in the treatment of Sheila Martin’s third-party statement as well. Although the administrative law judge gave her statement some weight, he did not identify which limitations were included in the residual functional capacity or explain which additional limitations were unsupported by the medical evidence. A general statement that the medical evidence did not support more restrictions was insufficient.

Remedy and Disposition

The court applied the “credit as true” rule, which can require an award of benefits when the administrative law judge improperly rejected evidence, the record is complete, and the record leaves no serious doubt about disability. The court concluded that properly crediting the rejected opinions and testimony would result in a significantly more restrictive residual functional capacity, including an inability to maintain a regular work schedule. The vocational expert had testified that the identified jobs would not be available to a person with those limitations.

Judge Joseph C. Spero granted J.M.’s motion for summary judgment, denied the Commissioner’s cross-motion for summary judgment, and remanded to the Commissioner for calculation and award of benefits. The court stated that no further administrative proceedings were required. The court did not decide J.M.’s separate challenge concerning physical impairments because the same ultimate result followed from the errors involving the mental-health evidence and testimony.