K.J. v. Kijakazi

Background

K.J. sought judicial review of the Commissioner of Social Security’s decision denying his claim for Social Security Disability Insurance benefits under Title II of the Social Security Act. K.J. alleged disability based on post-traumatic stress disorder, scoliosis, back pain, asthma or allergies, and joint pain. After an earlier district-court remand, the administrative law judge issued a second unfavorable decision. The administrative law judge found that K.J. had severe degenerative disk disease, asthma, post-traumatic stress disorder, and depressive disorder. The judge determined that K.J. could perform light work with several physical and mental restrictions, could not perform his past relevant work, but could perform jobs such as office helper, electronics worker, and routing clerk.

The parties filed cross-motions for summary judgment. K.J. argued that the administrative law judge improperly evaluated the Department of Veterans Affairs’ disability rating, medical opinions, K.J.’s residual functional capacity, K.J.’s testimony about pain and limitations, and his wife’s testimony.

Rulings

The court granted K.J.’s motion for summary judgment, denied the Commissioner’s cross-motion for summary judgment, and remanded for further proceedings.

Department of Veterans Affairs rating

The Department of Veterans Affairs had designated K.J. permanently and totally disabled and found him unemployable as of August 8, 2013. The court explained that the administrative law judge had to consider that determination and generally give it great weight, although the determination was not binding. The administrative law judge gave it less than great weight based on three reasons: the medical record allegedly did not show persistent post-traumatic-stress-disorder problems before the date last insured; a VA record included a negative screening result; and a later treatment provider had not supplied session notes or objective findings supporting total disability.

The court held that these reasons were not persuasive. The record included a positive post-traumatic-stress-disorder screen from 2011, and the VA had relied on the entire claim file and a 2014 mental examination. The negative screening result was only one screening, and the later treatment statements could not have been considered by the VA when it issued its earlier determination. The court remanded on this ground.

Medical opinions

The court held that the administrative law judge improperly discounted opinions from treating physician Kirk G. Andrus, M.D., and examining psychologist Melody Samuelson, Psy.D. As to Dr. Andrus, the administrative law judge said his opinion was too restrictive and inconsistent with improved back imaging, daily activities, and conservative treatment. The court found that the imaging rationale was not supported by substantial evidence because the administrative law judge relied on an X-ray without explaining whether it addressed the source of K.J.’s back pain. The court also found the discussion of daily activities and conservative treatment conclusory.

As to Dr. Samuelson, the administrative law judge again relied on K.J.’s daily activities and on negative depression and post-traumatic-stress-disorder screenings. The court held that the administrative law judge did not explain why those facts were inconsistent with Dr. Samuelson’s opinion that K.J. needed a structured work setting. The court remanded on the medical-opinion issues.

Residual functional capacity

Residual functional capacity means the most a claimant can do despite his impairments. Because the administrative law judge’s residual-functional-capacity assessment was based partly on the medical evidence that had been improperly evaluated, the court remanded for reconsideration of the residual functional capacity as well.

K.J.’s symptom testimony

The court held that the administrative law judge improperly rejected K.J.’s testimony about the severity of his pain and other limitations. The administrative law judge found that K.J.’s impairments could reasonably cause the alleged symptoms and did not identify evidence of malingering. The administrative law judge therefore had to give specific, clear, and convincing reasons for rejecting the testimony. Instead, the administrative law judge cited inconsistencies with K.J.’s daily activities without identifying which specific testimony was not credible. The court found that error warranted remand.

Wife’s testimony

The court also remanded regarding testimony from K.J.’s wife. Lay-witness testimony about a claimant’s symptoms and daily activities must be considered and may not be disregarded without comment. If an administrative law judge discounts it, the judge must give specific reasons connected to that witness. The administrative law judge gave the wife’s testimony limited weight, calling it cumulative, overly restrictive, inconsistent with medical evidence and activities, and a subjective opinion from a nonmedical source. Because the court was already requiring reconsideration of K.J.’s testimony and the medical opinions, it remanded on this issue too.

Disposition

The court concluded that further administrative proceedings could remedy the identified defects. It therefore granted K.J.’s motion, denied the Commissioner’s cross-motion, and remanded for further proceedings consistent with the order. The opinion did not award benefits immediately.