Floyd K. v. Kijakazi

Background

Floyd K. applied for disability insurance benefits and supplemental security income on February 12, 2018. He alleged that he became disabled on September 1, 2017, based on post-traumatic stress disorder, depression, high blood pressure, illiteracy, and antisocial behavior or anger flare-ups.

After a hearing at which Floyd K. was represented by counsel, the administrative law judge (ALJ) found that Floyd K. had severe impairments including asthma, chronic kidney disease, hypertension, degenerative disc disease, dysthymic disorder, major depressive disorder, post-traumatic stress disorder, stimulant use disorder, and mild to moderate intellectual disability. The ALJ found that Floyd K. could perform medium work subject to restrictions involving hazardous machinery, unprotected heights, task complexity, workplace stress, and interactions with the public and coworkers. Based on vocational-expert testimony, the ALJ found that he could work as a kitchen helper, laboratory equipment cleaner, or hand packager and therefore was not disabled.

The Conflicting Psychological Opinions

Floyd K. was examined by psychologists Aparna Dixit and Laura Jean Catlin. Dixit’s examination and testing reflected some cognitive limitations but generally intact functioning. Dixit opined that Floyd K. would have no significant difficulty remembering and following simple instructions, although he would have impairments involving complex instructions, working with the public, and mental flexibility.

Catlin’s examination and testing produced substantially more severe results. Catlin reported severe impairment on the Repeatable Battery for the Assessment of Neuropsychological Status, severe depression, and a full-scale intelligence quotient score of 48. She opined that Floyd K. had marked or extreme limitations in many areas of work functioning and would miss more than four workdays per month.

The ALJ gave great weight to Dixit’s opinions and discounted Catlin’s opinions. The ALJ found Dixit’s opinions supported by the examination, standardized testing, other medical evidence, and Floyd K.’s reported daily activities. The ALJ found Catlin’s opinions inconsistent with her examination findings, other medical records, Floyd K.’s testimony, and his function report, and found that Catlin relied in part on his reports of severe symptoms.

Court’s Analysis

For disability applications filed after March 27, 2017, the Social Security regulations require the Commissioner to evaluate the persuasiveness of medical opinions, especially their supportability and consistency. The regulations do not require automatic deference to treating physicians, but the ALJ must explain how the medical opinions were considered and how persuasive they were found to be.

The court concluded that the ALJ did not address Floyd K.’s challenge concerning the Dixit examination. Floyd K. testified that the mental-health appointment lasted about 30 minutes and that Dixit only asked him questions. He argued that the testing described in Dixit’s report generally would take substantially longer. The court found the testimony ambiguous about which appointment Floyd K. was describing, but concluded that the uncertainty about the examination’s length and the tests Dixit performed required further development of the record.

An ALJ has a duty to fully and fairly develop the record when the evidence is ambiguous or inadequate. The court stated that this duty applies even when the claimant has counsel and is heightened when the claimant has a mental illness that may limit his ability to protect his interests. Because the ALJ did not address the ambiguity about Dixit’s examination, the court remanded for further development on that limited issue. The court did not reach Floyd K.’s remaining arguments concerning his testimony or the residual functional capacity finding because those issues were related to the ALJ’s evaluation of the psychological opinions.

Disposition

Judge Sallie Kim granted Floyd K.’s motion for summary judgment and denied the Commissioner’s cross-motion for summary judgment. The court vacated the Commissioner’s final decision and remanded the matter for further administrative proceedings consistent with the order. The court stated that a separate judgment would issue and that the clerk would close the file.