P.H. v. Saul

Background

P.H. sought judicial review of the Commissioner of Social Security’s decision denying her applications for disability insurance benefits and supplemental security income. She alleged disability beginning November 1, 2016, based on depression, anxiety, post-traumatic stress disorder, hypertension, a back injury, sciatica, and diabetes.

The administrative law judge found that P.H. had severe impairments including major depressive disorder, essential hypertension, chronic female pelvic pain, and post-traumatic stress disorder. The judge determined that she could perform medium work with several mental and workplace restrictions, including simple, routine, and repetitive tasks; limited workplace changes and public interaction; no teamwork; no fast-paced production requirements; and being off task less than 10 percent of the workday. Although the judge found that P.H. could not perform her past relevant work, he found that she could perform other jobs existing in significant numbers in the national economy and therefore was not disabled.

Issues and analysis

P.H. challenged the administrative law judge’s evaluation of opinions from licensed clinical social worker Marike Seeman, psychologist Aparna Dixit, and physician Farah Rana. The court explained that, depending on which Social Security regulations applied, medical opinions had to be evaluated under either the earlier treating-physician framework or the regulations that evaluate opinions primarily for supportability and consistency. Under either framework, the court found that the administrative law judge properly evaluated Dr. Dixit’s opinion but improperly evaluated Dr. Rana’s opinion.

Seeman had provided counseling to P.H. and completed mental-health questionnaires describing moderate to marked limitations in several areas, including concentration, maintaining pace, understanding and applying information, and managing herself. She also stated that P.H. would likely miss four or more workdays per month and be off task 25 percent of the time. The administrative law judge summarized Seeman’s findings but did not explain the importance assigned to her opinion or account for it in the residual functional capacity assessment. The Commissioner conceded that this error required a remand.

Dr. Dixit conducted a mental-status examination and assessed mostly mild or no work-related limitations. The administrative law judge gave her opinion partial weight and found it more consistent with the record than an earlier evaluation that assessed more severe limitations. The court held that the administrative law judge’s evaluation of Dr. Dixit’s opinion was supported by substantial evidence, meaning relevant evidence that a reasonable person could accept as adequate. The court found no error in that part of the decision.

Dr. Rana evaluated P.H.’s physical condition and opined that she could perform light work, including standing and walking for six hours with breaks, sitting for six hours with breaks, and carrying up to 20 pounds occasionally. The administrative law judge gave that opinion partial weight, reasoning that the diagnoses were described as historical or probable and lacked objective support. The court concluded that the judge had not clearly shown that he considered all relevant evidence, including records referring to lumbar spinal stenosis and a fibroid, when discounting Dr. Rana’s opinion. The court therefore found the reasons given for discounting that opinion insufficient.

Remand and disposition

P.H. asked the court to order immediate payment of benefits under the credit-as-true doctrine, which can permit a court to treat improperly rejected evidence as true when specified conditions are met. The court declined to order immediate payment because unresolved issues remained, including how the administrative law judge would evaluate Seeman’s and Rana’s opinions and whether those evaluations would change P.H.’s residual functional capacity or ability to work.

Judge Demarch granted in part and denied in part P.H.’s motion for summary judgment, granted in part and denied in part the Commissioner’s cross-motion for summary judgment, and remanded the matter for further administrative proceedings consistent with the order. The clerk was directed to enter judgment and close the file.