A.P. v. Kijakazi

Background

A.P. applied for disability insurance benefits and supplemental security income, alleging disability beginning March 26, 2020. She identified physical and mental conditions related to a COVID-19 infection, pneumonia, anxiety, depression, and post-traumatic stress disorder. The administrative law judge, or ALJ, found severe impairments including the effects of COVID-19 and pneumonia, obesity, diabetes, anxiety, depression, and post-traumatic stress disorder.

The ALJ found that A.P. had not engaged in substantial work activity, that her impairments did not meet or equal a listed impairment, and that she could not perform her past relevant work. The ALJ nevertheless found that A.P. had the residual functional capacity—the abilities remaining despite her impairments—to perform a limited range of light work. Based on vocational-expert testimony, the ALJ found that jobs such as photocopy machine operator, non-postal mail clerk, and office helper existed in significant numbers. The ALJ therefore found A.P. not disabled. The Appeals Council declined review, making the ALJ’s decision the Commissioner’s final decision.

Arguments and analysis

A.P. argued that the ALJ failed to obtain additional workers’ compensation records, failed to consider the effect of obesity at the third step of the disability analysis, and improperly rejected her testimony about the severity of her symptoms. The opinion states that A.P. raised “four grounds,” but it lists three arguments.

The court rejected the argument about the workers’ compensation records. At least some of those records were already in the administrative record, and the ALJ discussed a workers’ compensation medical report. A.P. did not explain why the records already included were ambiguous or inadequate, so the court found no error in the ALJ’s development of the record.

The court also rejected the obesity argument. It explained that obesity is not itself a separately listed impairment, although obesity can contribute to an impairment that equals a listed impairment. The ALJ’s duty to analyze obesity’s combined effects was triggered only if A.P. presented evidence supporting such equivalence. A.P. did not identify a listing or provide a supporting theory or evidence. The court also noted that the ALJ expressly considered obesity and related medical findings at step three.

The court agreed with A.P. that the ALJ improperly evaluated her symptom testimony. Because the ALJ found that A.P.’s impairments could reasonably cause the alleged symptoms and did not find malingering, the ALJ needed specific, clear, and convincing reasons supported by substantial evidence to reject the testimony about the severity of those symptoms.

The court found that the ALJ did not adequately connect the medical evidence to the testimony being rejected. The ALJ summarized breathing, heart-rate, body-mass-index, cardiac, neurological, musculoskeletal, gait, and extremity findings, but did not explain why those findings contradicted A.P.’s reports that she became winded during ordinary activities such as standing, speaking, and walking. The court also found that the ALJ did not address family statements and physical-therapy reports supporting A.P.’s limited functional capacity.

The court further found that the ALJ mischaracterized A.P.’s daily activities. Although A.P. could perform some tasks, she testified that she had to do dishes and prepare meals in increments, needed help with laundry and other chores, could not sweep or mop or shop independently, and needed accompaniment outside the home because of severe anxiety. The court concluded that these activities were not shown to occupy a substantial part of her day or to be transferable to a work setting.

Finally, the court concluded that the ALJ improperly relied on A.P.’s limited treatment history. The opinion states that a claimant’s failure to obtain treatment because of financial problems cannot properly be used to deny disability benefits. The record indicated that A.P. lacked insurance when she could not obtain some treatment.

Harm and disposition

The court found these errors harmful rather than harmless. The ALJ’s rejection of A.P.’s testimony affected the residual-functional-capacity finding, which in turn supported the finding that jobs existed that A.P. could perform. The court therefore could not conclude that the errors were inconsequential to the disability determination.

The court declined to order immediate calculation of benefits. It found that further proceedings could help resolve inconsistencies in the record, including differing explanations for A.P.’s discontinued use of a walker and the end of physical therapy. The court therefore remanded the case to the ALJ for further proceedings.

The order granted A.P.’s motion for summary judgment and denied defendants’ cross-motion for summary judgment.