Paula W. v. Kijakazi

Background

Paula W. applied for Social Security Disability Insurance benefits, alleging disability beginning May 4, 2018. The administrative law judge found severe impairments including obesity, psychogenic non-epileptic spells, anxiety disorder, depressive disorder, and somatic symptom disorder. The administrative law judge determined that Paula W. could perform medium work with restrictions, including avoiding certain hazards and performing only simple, repetitive tasks with limited workplace interaction. Relying on vocational-expert testimony, the administrative law judge found her not disabled.

After the Appeals Council denied review, Paula W. sought review under 42 U.S.C. § 405(g). She challenged the Appeals Council’s handling of new evidence, the administrative law judge’s failure to develop the record about her mental impairments and psychogenic non-epileptic spells, the evaluation of her obesity, the rejection of her treating therapist’s opinion, the evaluation of her symptom testimony, and the constitutionality of the Commissioner’s appointment and removal structure.

New Evidence

The court held that the Appeals Council erred by refusing to consider most of the additional evidence because it postdated Paula W.’s date last insured or the administrative law judge’s decision. The evidence included medical records from Salinas Valley Medical Clinic, Mee Memorial Hospital, and Monterey County Behavioral Health Department, along with a January 2021 functional assessment from Nurse Jones.

The court concluded that all five categories of evidence were new and material and that there was a reasonable probability they could change the disability determination. The records concerned the same chronic seizures, anxiety, depression, and somatic symptom disorder considered by the administrative law judge. The court also found that the evidence could affect the evaluation of Paula W.’s symptom testimony and the medical-opinion evidence.

The court remanded so the administrative law judge could consider the new evidence. It did not reach Paula W.’s related challenges to the evaluation of her therapist’s opinion and her symptom testimony, directing that those issues be reconsidered in light of the new evidence.

Failure to Develop the Record

The court also held that the administrative law judge failed to adequately develop the record concerning the functional limitations associated with Paula W.’s mental impairments and psychogenic non-epileptic spells. The state agency consultants’ opinions were rejected because they incorrectly found no evidence of seizures before the date last insured. The administrative law judge also rejected the opinion of Paula W.’s treating therapist, Cienna Bancroft.

As a result, the administrative law judge relied on no medical opinion addressing how the seizures and mental impairments affected Paula W.’s ability to work. The court found the record inadequate or ambiguous on that issue and concluded that the administrative law judge could not substitute personal judgment for medical evidence. On remand, the additional opinion from Nurse Jones might eliminate the need for another medical expert, depending on the weight assigned to it. If that opinion is rejected, the administrative law judge must further develop the record regarding the relevant functional limitations.

Obesity

The court rejected Paula W.’s argument that the administrative law judge failed to evaluate the effects of obesity. The administrative law judge recognized obesity as a severe impairment, noted a body mass index of 48.4, and considered its functional effects at an earlier step of the disability analysis. The court found no medical evidence showing that obesity caused additional limitations or worsened the other impairments. Remand was not warranted on this ground.

Constitutional Challenge

The Commissioner conceded that the statutory restriction on the President’s ability to remove the Commissioner violates separation-of-powers principles to the extent it limits presidential removal authority. But the court applied Ninth Circuit precedent holding that a claimant must show actual, particularized harm from that restriction before receiving relief.

The court found that Paula W. had not shown that the removal restriction affected her case. It therefore rejected her request for a new hearing before a different administrative law judge on that basis. The court emphasized that the constitutional issue was not the reason for remanding the case.

Disposition

Judge Ryu granted in part and denied in part Paula W.’s motion for summary judgment, denied the Commissioner’s cross-motion for summary judgment, and remanded the case for further proceedings. Because the record did not clearly require a finding that Paula W. was disabled, the court did not order an immediate award of benefits.