I. v. Kijakazi

Background

K. I. sought supplemental security income under Title XVI of the Social Security Act. The claim alleged disability beginning March 11, 2017, based on physical and mental impairments, including a gunshot injury to the spine, depression, anxiety, and bipolar disorder. An administrative law judge (ALJ) denied the claim after finding that K. I. had severe depression with psychotic features and an anxiety disorder, but retained the capacity to perform work at all exertional levels with limits on tasks, workplace interactions, and stress. The Appeals Council declined review.

K. I. and Kilolo Kijakazi filed cross-motions for summary judgment. Summary judgment asks the court to decide the case based on the administrative record rather than conduct a trial.

Medical-opinion evidence

The court held that the ALJ’s evaluation of the medical evidence was not supported by substantial evidence. The court found errors in the ALJ’s treatment of the opinions of examining psychologist Nicole Kirsch, treating psychiatrist Said Shefayee, and treating therapist Jonathan Oakes.

As to Dr. Kirsch, the court held that the ALJ improperly discounted opinions that K. I. was extremely limited in interacting with others, completing a normal workday, and maintaining regular attendance. The ALJ had relied on evidence that K. I. interacted productively with mental-health providers while incarcerated and completed coursework. The court found that the ALJ failed to discuss other evidence supporting Dr. Kirsch’s opinions, including examination observations, reported anxiety symptoms, and testing showing severe anxiety and elevated post-traumatic-stress symptoms.

The court also held that the ALJ improperly rejected Dr. Kirsch’s opinions about attendance and completing a normal workday. The ALJ had not addressed supporting information about K. I.’s difficulty with supervisors, anxiety-related inability to get out of bed, inconsistent cooperation during the examination, history of psychiatric treatment, and testimony about problems maintaining employment.

The court partly upheld the ALJ’s rejection of Dr. Shefayee’s and Mr. Oakes’s opinions. Substantial evidence supported rejecting their opinions that K. I. had marked limitations in understanding, remembering, and carrying out even simple instructions. Treatment notes described K. I. as cooperative, able to communicate properly, and a reliable historian, and indicated that hallucinations had subsided with treatment. But the court held that substantial evidence did not support rejecting their opinions about limitations involving attendance, completing a normal workday, working near others, handling normal work stress, sustaining an ordinary routine without special supervision, and accepting supervision.

The court also held that the ALJ erred in giving persuasive weight to the opinions of state-agency psychological reviewers without adequately considering that they lacked a treatment relationship with K. I. and issued their opinions before much of the later behavioral-health evidence was available.

Subjective symptom testimony

The court held that the ALJ improperly rejected K. I.’s testimony about the severity of his symptoms. The ALJ used a general statement that the testimony was inconsistent with the medical and other evidence, followed by summaries of the record, but did not identify specific inconsistencies or connect the testimony to particular supporting evidence.

The court further explained that any improvement with medication had to be assessed in context. The ALJ needed to consider whether K. I.’s improved functioning resulted from a stable institutional environment with regular access to treatment and medication, and whether that improvement showed an ability to work outside that setting. The court concluded that the ALJ’s reasons did not meet the required clear-and-convincing standard.

Issues not reached and disposition

Because the errors concerning the medical evidence and symptom testimony affected the disability determination and were not harmless, the court did not decide K. I.’s additional arguments concerning the ALJ’s step-two and step-three findings or the residual functional capacity assessment.

K. I. asked either for an award of benefits or for further proceedings. The court determined that the record was not fully developed and that it was not clear K. I. would be found disabled if the improperly rejected evidence were credited. The court therefore granted K. I.’s motion, denied Kijakazi’s cross-motion, and remanded for further proceedings consistent with the order.