Kellie W. v. Kijakazi

Background

Kellie W. applied for Social Security Disability Insurance benefits, alleging disability beginning August 9, 2016. After an initial denial, reconsideration denial, and an administrative hearing, an administrative law judge issued an unfavorable decision. The Appeals Council declined review. Following an earlier related proceeding, the matter was remanded to the Social Security Administration for further proceedings because the administrative law judge had not fully and fairly developed the record. On remand, another administrative law judge held a hearing and again found that Kellie W. was not disabled.

The administrative law judge found that Kellie W. had severe impairments including degenerative disc disease, major depressive disorder, and post-traumatic stress disorder. The judge determined that she could perform light work with restrictions, could not perform her past relevant work, but could perform other jobs existing in significant numbers in the national economy.

Issues and analysis

Kellie W. challenged the evaluation of opinions from Dr. Ives, her treating psychologist; Dr. Samuelson, an agency psychological examining consultant; and Dr. Tirado, an agency non-examining psychologist. She also challenged the hypothetical used at the final step of the disability analysis and the evaluation of her subjective statements.

The court held that the administrative law judge failed to give adequate reasons for assigning only “partial weight” to Dr. Ives’s opinion. The judge cited Kellie W.’s ability to regain her nursing license, current work activity, mental-status examinations and Global Assessment of Functioning scores, and daily activities. But the court found that the judge did not explain how those matters contradicted Dr. Ives’s opinions about Kellie W.’s limitations during the earlier period at issue. The court also found that the judge did not clearly show that the regulatory factors for evaluating a treating source’s opinion had been considered, including the treatment relationship, supportability, consistency, and specialization.

The court likewise held that the administrative law judge inadequately evaluated Dr. Samuelson’s opinion. The judge referred to limited mental-status examinations and Kellie W.’s current work activity but did not identify or explain the cited examinations or explain how the later work activity contradicted an opinion about an earlier period. The fact that Dr. Samuelson examined Kellie W. only once, by itself, was not a sufficient reason to discount an examining physician’s opinion.

Because the opinions of Dr. Ives and Dr. Samuelson required reconsideration, the court found it premature to decide whether the administrative law judge properly evaluated Dr. Tirado’s opinion. The court also found that Kellie W.’s remaining arguments depended substantially on the medical-opinion analysis and therefore were premature. The agency was directed to consider those arguments during reconsideration.

Disposition

The court concluded that further administrative proceedings were appropriate because unresolved issues remained and the record did not clearly require a finding that Kellie W. was disabled even if the evidence were properly evaluated. It granted Kellie W.’s motion for summary judgment, denied the Commissioner’s cross-motion for summary judgment, reversed the administrative law judge’s decision, and remanded the matter for further administrative proceedings consistent with the order. The court did not direct an immediate award of benefits.