Smith v. Saul

Background

Melvina N. Smith sought judicial review of the Social Security Administration’s denial of her application for supplemental security income. Smith had previously received Title II disability benefits based on bipolar disorder, but the Commissioner later found that her disability ended as of July 1, 2011. That decision became final after Smith did not appeal it.

Smith reapplied for benefits in February 2015. Administrative Law Judge Arthur Zeidman found that new evidence showed changed circumstances sufficient to reconsider the disability issue, including revisions to a mental-impairment listing and a change in Smith’s age category. After a January 2018 hearing, the administrative law judge found that Smith had severe physical and mental impairments, including degenerative disc disease, osteoarthritis, pancreatitis, obesity, bipolar disorder, and alcohol use disorder.

The administrative law judge found Smith disabled when considering all of her impairments. But the judge then evaluated which limitations would remain if Smith stopped using alcohol. The judge concluded that Smith would no longer be absent from work 20 percent of the time and could perform her past work. Based on that conclusion, the judge decided that substance use was a contributing factor material to the disability determination and found Smith not disabled.

The parties’ arguments

Smith moved for summary judgment, asking the court to hold that the administrative law judge’s decision was erroneous. Among other arguments, Smith contended that the judge improperly found alcohol use material to her disability and improperly rejected the opinion of examining psychologist Ahmed El-Sokkary.

The Commissioner argued that Smith’s mental-status examinations in 2015 were generally unremarkable and that El-Sokkary’s opinion was inconsistent with other evidence. The Commissioner also relied on two 2016 hospitalizations for pancreatitis as evidence related to Smith’s alcohol use.

Court’s analysis

Under the Social Security Act, the court reviews the Commissioner’s final decision and may reverse it when it rests on legal error or factual findings unsupported by substantial evidence. Substantial evidence means relevant evidence that a reasonable person could accept as adequate support for a conclusion.

Alcohol use and materiality

The court held that the administrative law judge’s finding that Smith’s alcohol use was a material, contributing factor to her disability was not supported by substantial evidence. In this context, “material” means that the claimant would not be disabled if she stopped using drugs or alcohol.

The administrative law judge relied on Smith’s two 2016 emergency-room visits for pancreatitis but did not adequately address her broader medical history. The court noted that Smith’s extensive records generally did not identify an alcohol or drug problem, indicate that she arrived intoxicated for appointments, or show that her regular providers were concerned about her alcohol use. State-agency consultants also reported that the record contained no evidence of a substance-abuse disorder issue.

The court further stated that the record did not establish that Smith’s mental and physical limitations would disappear or improve to the point of non-disability if she stopped using alcohol. The court therefore concluded that the materiality finding was reversible error.

Psychologist El-Sokkary’s opinion

The court also held that the administrative law judge improperly rejected El-Sokkary’s examining opinion. El-Sokkary concluded that Smith had limited ability to understand, remember, and perform simple tasks; difficulty maintaining concentration, persistence, and pace in a competitive work setting; difficulty communicating with supervisors and coworkers; and difficulty maintaining a regular work schedule.

Because El-Sokkary examined Smith and his opinion was contradicted by other medical opinions, the administrative law judge needed specific and legitimate reasons supported by substantial evidence to reject it. The court found that the judge did not provide those reasons.

The judge criticized El-Sokkary for not reviewing the pancreatitis records and for findings that allegedly conflicted with treatment notes showing generally normal mental-status examinations. The court found this reasoning inadequate, in part because the administrative law judge had himself found moderate limitations in the same areas identified by El-Sokkary. The court also found that El-Sokkary’s descriptions of Smith’s ability to perform light cooking and cleaning were not inconsistent with his statements that she needed help with daily activities and had an in-home care provider.

Remedy

The court considered whether to send the case back for more administrative proceedings or order immediate payment of benefits. It applied the “credit-as-true” doctrine, which can allow a court to treat improperly rejected evidence as true and order benefits when the administrative law judge gave legally insufficient reasons, no unresolved issues require further development, and the record leaves no serious doubt that the claimant is disabled.

The court found that the record was fully developed and that Smith’s extensive mental and physical impairments left no doubt about her disability. It therefore remanded the case for immediate payment of benefits.

Disposition

The court granted Smith’s motion for summary judgment, denied the Commissioner’s cross-motion for summary judgment, reversed the denial of benefits, and remanded the case under sentence four of 42 U.S.C. § 405(g) for immediate payment of benefits.