Muang M. v. Kijakazi

Background

Muang M. sought Title II Social Security disability benefits based on physical conditions including tears in both rotator cuffs, neck pain, cervicalgia, and chronic pain syndrome. The Social Security Administration denied her application initially and on reconsideration. After hearings, an administrative law judge (ALJ) found that she had several severe impairments but retained the capacity to perform light work, with restrictions including no overhead reaching, limited pushing, pulling, handling, fingering, and reaching, and no ladder, rope, or scaffold climbing. The ALJ concluded that she was not disabled because she could perform jobs existing in significant numbers in the national economy. The Appeals Council denied review.

The parties filed cross-motions for summary judgment, asking the district court to decide whether the ALJ’s decision was legally supported.

Medical-opinion evidence

The court held that the ALJ improperly rejected opinions from Muang M.’s treating and examining medical providers, Drs. Campbell, Martinovsky, and Hanley. Those providers concluded that she could not lift more than five to ten pounds, but the ALJ included no lifting restriction in the residual functional capacity finding.

The ALJ gave the opinions limited weight because the providers were not state-agency consultants trained in the disability program and because the longitudinal medical record supposedly showed normal and stable examinations. The court found that the providers’ status as treating or examining physicians, rather than state-agency consultants, was not a valid reason to discount their medical judgments about Muang M.’s lifting ability. The court also found that the ALJ selectively relied on limited evidence while ignoring other records documenting shoulder tears, pain, reduced strength and range of motion, positive examination tests, difficulty lifting and reaching, and difficulty with activities such as bathing and dressing.

The court did not need to decide whether the newer Social Security regulations changed the prior standards for evaluating medical opinions. It concluded that the ALJ’s reasoning was inadequate under either approach. Because the ALJ failed to properly consider the treating and examining providers’ opinions, the court directed that the medical evidence be reevaluated on remand.

Pain testimony

The ALJ found that Muang M.’s medically determinable impairments could reasonably cause her alleged symptoms and found no evidence that she was pretending to be ill. The ALJ therefore needed adequate reasons for rejecting her testimony about the intensity and limiting effects of her pain.

The ALJ relied on two reasons: that Muang M. received conservative treatment and that she could perform some daily activities, including light household chores and driving. The court found neither reason sufficient.

Regarding treatment, the ALJ did not consider explanations for Muang M.’s decision not to undergo a second surgery for her re-torn right rotator cuff. The court held that an ALJ cannot use a claimant’s failure to pursue more aggressive treatment against the claimant without considering why the treatment was not pursued.

Regarding daily activities, the court held that light cleaning, some cooking, watering the yard, and driving did not show that Muang M. could sustain a typical workday. Those activities therefore did not, by themselves, undermine her testimony about chronic pain.

Other arguments and remedy

Because the ALJ’s evaluation of the medical evidence and pain testimony was unsupported by substantial evidence, the errors were not harmless. The court did not reach Muang M.’s additional argument concerning the ALJ’s finding at the final step that sufficient jobs existed in the national economy.

Muang M. requested either payment of benefits or further proceedings. The court determined that further proceedings were appropriate because the record was not fully developed, unresolved issues remained, and it was not clear that properly crediting the disputed evidence would necessarily require a finding of disability. The vocational testimony had been based on an ability to perform light work, so a different finding about Muang M.’s lifting capacity could affect the disability determination.

Disposition

Judge Jacquelyn Corley granted Muang M.’s motion for summary judgment, denied the Commissioner’s cross-motion, and remanded the case for further proceedings consistent with the order.