Kenneth P. v. Saul

Background

Kenneth P. sought judicial review of an administrative law judge’s denial of his application for supplemental security income under Title XVI of the Social Security Act. The Appeals Council denied review, making the administrative law judge’s decision the final decision of the Commissioner of Social Security. Both sides moved for summary judgment, which asks the court to decide the case based on the administrative record without a trial.

Kenneth P. had a lengthy documented history of mental illness, psychiatric hospitalizations, suicide attempts and ideation, depression, anxiety, bipolar disorder, post-traumatic stress disorder, personality disorder, psychotic symptoms, and substance-use disorder. The administrative law judge found severe impairments including Crohn’s disease, major depressive disorder, stimulant-use disorder, and cannabis-use disorder. The judge found that personality disorder and post-traumatic stress disorder were not severe, and did not address anxiety disorder, bipolar disorder, or mood disorder with psychotic features at the second step of the disability analysis.

The administrative law judge relied heavily on testimony from Nathan Strahl, M.D., a non-examining psychiatric expert. Dr. Strahl testified that, if Kenneth P. stopped using substances, his mental limitations would be mild to moderate and he could perform certain jobs. The administrative law judge therefore determined that substance use was a material contributing factor to disability and denied the application.

Court’s analysis

The court held that the administrative law judge’s second-step findings were not supported by substantial evidence. At that step, the claimant must show a medically severe impairment, but the test is a low threshold intended to screen out only minor or plainly groundless claims. The court concluded that the medical evidence clearly established that Kenneth P.’s mental impairments were not groundless. The administrative law judge could not treat post-traumatic stress disorder and personality disorder as non-severe merely because they appeared less frequently in the record, and the judge failed to address several other diagnosed conditions at all.

The court also held that the administrative law judge failed to adequately develop the record regarding the effect of drug addiction on Kenneth P.’s mental limitations. The court found Dr. Strahl’s opinion inadequate because he had not examined or treated Kenneth P., had not shown sufficient familiarity with the record, and offered no reasonable evidentiary explanation for concluding that Kenneth P.’s mental impairments would produce little or no limitation without substance use. The court determined that the opinion was contradicted by the broader medical evidence and could not, by itself, constitute substantial evidence.

The court concluded that the administrative law judge improperly based the evaluation from the second step forward on Dr. Strahl’s opinion while overlooking the opinions of treating physicians and psychotherapists. The court directed the Commissioner either to restart the sequential evaluation from the second step without relying on Dr. Strahl’s opinion, or, if necessary, to obtain an opinion from Ted Aames, Kenneth P.’s treating psychotherapist, and then conduct the evaluation consistently with the court’s instructions.

Disposition

The court declined to decide Kenneth P.’s remaining arguments because they could be addressed on remand and might be affected by the required reevaluation. It ordered the Commissioner to consider those other arguments on remand and modify the resulting administrative law judge decision as appropriate.

The court granted Kenneth P.’s motion for summary judgment, denied the Commissioner’s cross-motion, and remanded the case for further proceedings. The opinion did not itself award benefits.