Lauren M. v. Kijakazi

Background

Lauren M. sought judicial review under 42 U.S.C. § 405(g) of the Commissioner of Social Security’s denial of her application for disability insurance benefits. She alleged disability beginning March 1, 2011, based on post-traumatic stress disorder, adjustment disorder with depressed mood, major depressive disorder, and other mental-health conditions. The relevant insured period ended March 31, 2016.

In an earlier round of this case, the court granted Lauren M.’s motion for summary judgment, denied the Commissioner’s cross-motion, and sent the matter back for further administrative proceedings. The court had found that the administrative law judge did not adequately explain why he rejected a Veterans Affairs disability determination and an examining physician’s opinion. After further proceedings, the administrative law judge again found that Lauren M. was not disabled, concluding at the second step of the disability analysis that her mental impairments were not severe.

Analysis

The court reviewed whether substantial evidence supported the administrative law judge’s finding that Lauren M.’s impairments had no more than a minimal effect on her ability to work. The court emphasized that step two is a limited screening step and that an impairment may be found non-severe only when the evidence establishes a slight abnormality with no more than a minimal effect on work ability.

The court held that the administrative law judge improperly gave little weight to examining physician Dr. Dixit’s opinion. The fact that Dr. Dixit examined Lauren M. more than two years after the date last insured was not, by itself, a sufficient reason to reject the opinion, because later medical opinions can be relevant to a claimant’s earlier condition. The court also found that the administrative law judge did not identify which daily activities conflicted with Dr. Dixit’s opinion and did not independently establish that the concerns cited by non-examining medical expert Dr. McCain were legitimate reasons to discount Dr. Dixit’s opinion.

The court also held that substantial evidence did not support the administrative law judge’s reliance on Dr. McCain’s opinion. The court found that Dr. McCain and the administrative law judge selectively relied on evidence suggesting mild or controlled symptoms while overlooking later records describing weekly panic attacks and intermittent suicidal thoughts.

The court rejected the administrative law judge’s treatment of gaps in mental-health treatment as evidence against disability. The administrative law judge inferred that the Veterans Affairs system ended treatment because Lauren M.’s condition was not severe enough, but the record instead indicated that her therapist could no longer see her because of an influx of patients. Lauren M. also testified that she lacked insurance to obtain other treatment, and the administrative law judge did not address that testimony.

The court further held that Lauren M.’s daily activities, including caring for her children, could not independently support the non-disability finding. The administrative law judge did not explain why those activities were inconsistent with the effects of post-traumatic stress disorder and anxiety on her ability to focus, tolerate stressful environments, and interact with strangers.

Finally, the court held that the administrative law judge failed to provide persuasive, specific, and valid reasons for discounting the Veterans Affairs finding that Lauren M. was 100 percent totally and permanently disabled. General differences between the Veterans Affairs and Social Security disability programs were not enough. The administrative law judge also failed to adequately explain why the treatment record, Dr. McCain’s opinion, or Lauren M.’s daily activities justified rejecting the Veterans Affairs determination.

Disposition and Remand

The court granted Lauren M.’s motion for summary judgment and denied the Commissioner’s cross-motion. The court ordered Lauren M. to file supplemental briefing on whether the “credit-as-true” rule applied. That rule can permit an immediate award of benefits when the record is fully developed, the administrative law judge rejected evidence for legally insufficient reasons, and crediting that evidence would require a disability finding. The court stated that it would issue a further order addressing the scope of remand after the supplemental briefing. This opinion therefore did not decide whether the case would be remanded for additional proceedings or for an immediate award of benefits.