Tennille S. v. Kijakazi

Background

Tennille S. applied for Disability Insurance Benefits and Supplemental Security Income in August 2016, alleging disability beginning January 15, 2008. After an earlier round of this case resulted in a voluntary remand to the agency, an administrative law judge held a new hearing on October 19, 2021, and issued an unfavorable decision on November 15, 2021.

The administrative law judge found that Tennille S. had several severe physical and mental impairments, including lupus, degenerative disc disease, post-traumatic stress disorder, schizophrenia, bipolar disorder, major depressive disorder, and methamphetamine use disorder. The judge found that her impairments met the requirements of several listed mental disorders when substance use was included. But the judge concluded that substance use was a contributing factor material to the disability determination. In other words, the judge determined that Tennille S. would not be disabled if she stopped using substances. The judge therefore denied benefits.

Issues and Analysis

The court reviewed the Commissioner’s decision under the substantial-evidence standard, which requires more than a small amount of supporting evidence and requires the decision to be based on correct legal rules. Tennille S. challenged the administrative law judge’s treatment of medical opinions and her own symptom testimony.

The court held that the administrative law judge improperly discounted the opinions of treating doctors Paul Jurkowski and Aislinn Bird. The judge incorrectly described Dr. Jurkowski as an examining doctor who had seen Tennille S. only once, even though he was a treating doctor who had met with her three times before preparing his opinion. The court also found that the judge’s reasons for discounting Dr. Jurkowski’s opinion were not supported by substantial evidence. Dr. Jurkowski had reviewed medical records and laboratory results and had conducted mental-status examinations.

The court also held that the reasons given for discounting Dr. Bird’s opinion were legally insufficient. The administrative law judge did not discuss the required factors for evaluating a treating doctor’s opinion, inaccurately called Dr. Bird’s explanation conclusory, and improperly relied on the fact that Tennille S. was still using methamphetamine when Dr. Bird treated her. The court noted that agency guidance does not require evidence from a period of abstinence before a claimant can prove that substance use is not material to disability.

The court separately found legal error in the rejection of Tennille S.’s symptom testimony. The administrative law judge did not identify which specific statements were being rejected or explain why. The judge’s reliance on activities such as moving between shelters, using public transportation, generally normal physical examinations, the alleged lack of a prolonged period of sobriety, and supposed stabilization with medication and abstinence did not provide sufficiently specific and convincing reasons supported by the record.

Remedy and Disposition

The court applied the “credit-as-true” rule, under which improperly rejected testimony or medical opinions may be treated as true when the legal errors are established, no important issues remain, further proceedings would not be useful, and the record leaves no serious doubt about disability. The court found that the record was fully developed, that no further administrative proceedings would be useful, and that Tennille S. was disabled even without substance use. The treating doctors stated that her serious mental-health conditions predated substance use and would remain disabling without it. Their opinions also indicated that she would be absent from work or off-task at levels that, according to vocational-expert testimony, would prevent competitive employment.

The court GRANTED Tennille S.’s motion for summary judgment, DENIED the Commissioner’s cross-motion for summary judgment, and REMANDED the action under sentence four of 42 U.S.C. § 405(g) for immediate payment of benefits.