T.N. v. Kijakazi

Background

T.N. sought disability insurance benefits under Title II of the Social Security Act, alleging disability based on depression. The Social Security Administration denied her application. After an earlier related proceeding, the court remanded the matter for further consideration, including reassessment of T.N.’s symptom testimony, the medical opinions, her alleged onset date, her residual functional capacity, and whether she could perform other work.

On remand, Administrative Law Judge Evangelina Hernandez found that T.N. had major depressive disorder, anxiety, post-traumatic stress disorder, and obesity. The administrative law judge found that T.N. could perform work at all exertional levels with restrictions on hazards, task complexity, workplace stress, and interactions with others. The judge concluded that T.N. could not perform her past work but could perform jobs such as laundry worker, hospital cleaner, and scrap sorter. The Commissioner therefore again found that T.N. was not disabled between October 1, 2012, and December 31, 2014, her date last insured.

Medical Opinions

The court held that the administrative law judge failed to properly evaluate the opinions of treating psychiatrist Dr. Sangani and treating therapist Cheri Coulter. Dr. Sangani’s opinion described marked work-related limitations and stated that T.N. would be unable to complete a workday more than four days per month. The court found that Dr. Sangani treated T.N. regularly and extensively, was a psychiatrist, and gave an opinion consistent with the opinions of other treating providers.

The administrative law judge rejected Dr. Sangani’s opinion partly because Dr. Sangani supposedly lacked the state agency examiner’s superior understanding of Social Security rules and because the opinion was allegedly inconsistent with relatively normal mental-status findings and T.N.’s activities. The court found those reasons legally insufficient and unsupported by substantial evidence. It also found that the administrative law judge failed to apply the required factors, including the length, frequency, and nature of the treatment relationship, the opinion’s support, consistency, and the provider’s specialization.

The court reached similar conclusions regarding Ms. Coulter’s opinion. Ms. Coulter had treated T.N. weekly for more than three years, sometimes by telephone when T.N. could not leave home. The court found that her opinion was supported by her long-term observations and was consistent with other treating providers’ opinions. Although a licensed clinical social worker was not an “acceptable medical source” under the regulations applicable to this case, the court explained that such an opinion could still receive greater weight than opinions from providers who had seen the claimant less often or whose opinions were less supported or consistent.

The court also found that the administrative law judge improperly discounted the opinions of treating psychologists Drs. Vernita Marsh and Karen James. Although the ultimate disability determination belonged to the Commissioner, the psychologists’ opinions addressed medically based functional limitations, such as difficulty sustaining focus, maintaining prolonged workplace contact, and performing day-to-day activities. Those limitations were proper subjects of medical opinion and could not be rejected for the reasons given.

The court agreed that letters from therapists Ann Matsumoto and Cynthia Wiseman-Kelly were not medical opinions under the applicable regulation because they did not describe functional limitations caused by T.N.’s impairments.

Residual Functional Capacity and Step Five

Residual functional capacity is the most a claimant can do despite her impairments. The court held that the administrative law judge’s residual-functional-capacity finding was not supported by substantial evidence because it did not include the limitations described by Dr. Sangani and Ms. Coulter. Those providers stated that T.N. was unable to meet competitive standards in areas including regular attendance, completing a normal workday and workweek, responding to criticism, handling work stress, interacting with the public, and maintaining socially appropriate behavior. They also estimated that she would miss or be unable to complete a workday more than four days per month.

The court further held that the administrative law judge’s step-five finding was unsupported because the hypothetical given to the vocational expert did not include the proper limitations. The vocational expert testified that the restrictive limitations described by Dr. Sangani and Ms. Coulter would eliminate competitive employment.

The court declined to decide T.N.’s separate challenge to the administrative law judge’s evaluation of her symptom testimony because the errors concerning the medical opinions, residual functional capacity, and step-five analysis independently required relief.

Disposition

The court applied the Ninth Circuit’s “credit-as-true” rule, which can require an award of benefits when the administrative law judge legally rejected evidence, no unresolved issues require further proceedings, and the record leaves no serious doubt that the claimant was disabled. The court found that all three conditions were met. It concluded that the record supported the limitations described by Dr. Sangani and Ms. Coulter, that further administrative proceedings would not be useful, and that T.N. was disabled during the relevant period.

Judge Demarchi granted T.N.’s motion for summary judgment, denied the Commissioner’s cross-motion for summary judgment, and remanded the matter for an immediate calculation and award of benefits from October 1, 2012, through December 31, 2014. The court ordered the Clerk to enter judgment and close the case.