Palafox v. Saul

Background

Josephine Palafox sought judicial review of the Social Security Administration’s decision on her application for Supplemental Security Income and other benefits. The administrative law judge issued a partially favorable decision: Palafox was found not disabled before April 27, 2016, but disabled beginning on that date and continuing through the decision date. Because the administrative law judge found that Palafox was not disabled through June 30, 2015, the last date she was insured, she was not eligible for Title II benefits based on that period.

The administrative law judge found several physical impairments severe, including cervical-spine degenerative disc disease after decompression and fusion surgery, right elbow inflammation, right knee osteoarthritis, and right wrist tendonitis. The judge found depression and anxiety non-severe, determined that Palafox could perform sedentary work, and concluded at the final step of the disability analysis that she could perform work existing in significant numbers in the national economy.

Issues and analysis

Palafox argued that the administrative law judge improperly rejected her statements about the intensity and effects of her symptoms and improperly evaluated opinions concerning her mental limitations. The Commissioner argued that the decision was supported by sufficient evidence and contained no legal error.

The court agreed with Palafox’s first argument. When an administrative law judge does not find that a claimant is exaggerating or fabricating symptoms, and the claimant provides medical evidence of an impairment that could cause the alleged symptoms, the judge must give specific, clear, and convincing reasons for rejecting the claimant’s testimony about symptom severity.

The court found that the administrative law judge did not identify specific conflicts between Palafox’s testimony and her daily activities. The administrative law judge generally stated that some abilities involved in Palafox’s daily activities were also needed for employment, but did not explain which testimony was contradicted by which activities. The court also found that broad references to hundreds of pages of medical records did not identify what evidence conflicted with Palafox’s pain reports or explain how it did so.

The court further held that the error was not harmless. The lack of medical evidence alone could not justify rejecting Palafox’s pain testimony, and the administrative law judge had not provided sufficiently specific explanations for the remaining reasons. On remand, the administrative law judge must identify the testimony found not credible and link that testimony to the particular record evidence supporting the determination.

Unresolved arguments

Because the case was being sent back, the court did not decide Palafox’s arguments concerning the evaluation of medical opinions about depression and anxiety, the anxiety medication prescribed by a physician assistant, or a letter from a marriage and family therapist. The court stated that these matters could be addressed by the administrative law judge in the first instance on remand.

Disposition

Judge Haywood S. Gilliam, Jr. granted Palafox’s motion for summary judgment and denied the Commissioner’s cross-motion for summary judgment. The court remanded the case to the Social Security Administration for further proceedings on an open record consistent with the order, directed the Clerk to enter judgment for Palafox, and closed the case.