Miriam D. v. Kijakazi

Background

Miriam D. sought judicial review of an administrative law judge’s decision denying her application for disability benefits under Title II of the Social Security Act. Her second application was denied on August 5, 2021, and the Appeals Council also denied review. Both parties moved for summary judgment, which asks the court to decide the case based on the administrative record without a trial.

Miriam D. asked the court to remand the case with instructions to calculate and award benefits. The defendant acknowledged that the administrative law judge’s decision was not supported by substantial evidence and requested a remand for further administrative proceedings instead.

Issues and Evidence

Miriam D. challenged the administrative law judge’s evaluation of her pain and symptom testimony and certain medical opinions. The administrative law judge found that she had major depressive disorder, post-traumatic stress disorder, and generalized anxiety disorder. The administrative law judge nevertheless found that she could perform work at all exertional levels, subject to restrictions involving stress, decision-making, workplace changes, interaction with coworkers and the public, and production requirements.

Dr. Gupta, who performed a consultative examination, diagnosed major depressive disorder, post-traumatic stress disorder, and generalized anxiety disorder. Dr. Gupta found severe limitations in interacting with coworkers and the public, maintaining regular attendance, completing a normal workday and workweek without interruption, and dealing with ordinary workplace stress. The administrative law judge found this opinion unpersuasive.

Dr. De Hoyos, who had treated and observed Miriam D. since 2016, also diagnosed major depression, post-traumatic stress disorder, and anxiety. Dr. De Hoyos found that Miriam D. would be unable to meet competitive standards or would have no useful ability to function in many areas of work-related activity. The administrative law judge also found this opinion unpersuasive. State-agency psychologists offered less restrictive opinions, but the administrative law judge found those opinions only somewhat persuasive because they relied on the earlier 2019 non-disability decision and Miriam D. alleged that her symptoms had worsened.

Court’s Analysis

The court explained that it may set aside a denial of benefits when the decision is not supported by substantial evidence or is based on legal error. The parties did not dispute that the administrative law judge’s decision was erroneous. The remaining question was the appropriate remedy.

Miriam D. asked the court to apply the “credit-as-true” doctrine. Under that doctrine, a court may treat improperly rejected testimony or medical opinion evidence as true and remand for an immediate benefits award when the record is fully developed, the rejection lacked legally sufficient reasons, and crediting the evidence would require a finding of disability. The court stated that even when the doctrine’s conditions are met, further proceedings may still be appropriate if the record creates serious doubt about whether the claimant is disabled.

The court declined to apply the doctrine. It found that the record was not fully developed because the medical sources assessed different sets of limitations. Although Dr. Gupta and Dr. De Hoyos both described severe attendance-related limitations, neither quantified how much work Miriam D. might miss. The vocational expert testified generally about the number of absences that would prevent competitive employment, but no specific testimony addressed Miriam D.’s likely absences.

The court also identified differences between Dr. Gupta’s and Dr. De Hoyos’s opinions concerning Miriam D.’s ability to understand, remember, and carry out simple and repetitive tasks and to interact with supervisors. The court said the administrative law judge should have an opportunity to address the supportability and consistency of the state-agency opinions more specifically. The court further found that Miriam D.’s symptom testimony would benefit from additional development because she had not connected specific symptoms to particular work limitations, and parts of her testimony appeared potentially inconsistent with her reported travel and exercise activities.

Disposition

The court granted the defendant’s motion for summary judgment, denied Miriam D.’s motion for summary judgment, and remanded the matter for further proceedings consistent with the order. The administrative law judge was ordered to obtain an additional medical expert’s review and opinion and/or send questionnaires to the medical sources to clarify their opinions. The order did not direct an immediate award of benefits.