Lance P. v. Kijakazi

Background

Lance P. applied for disability insurance benefits under Title II of the Social Security Act. The relevant period was November 15, 2015, through September 26, 2017. In an earlier round of administrative proceedings, an administrative law judge found that Lance P. was not disabled during that period but became disabled on September 27, 2017. After a remand for further proceedings, a second administrative law judge again found that Lance P. was not disabled during the earlier period. The Appeals Council denied review, making that decision the Commissioner’s final decision.

Lance P. sought judicial review and asked for reversal of the denial and payment of benefits, or further administrative proceedings. The parties filed cross-motions for summary judgment. Summary judgment is a decision based on the existing record when there is no need for a trial to resolve the motion.

The Administrative Law Judge’s Decision

The administrative law judge found that Lance P. had severe impairments including degenerative changes in his left foot, arthritis or hallux limitus in the left foot, degenerative disc disease and facet arthropathy in the lumbar spine, irritable bowel syndrome, and other impairments identified in the decision. The judge determined that Lance P. could perform light work with limitations, including standing and walking for six hours and sitting for six hours in an eight-hour workday. Based on vocational-expert testimony, the judge found that Lance P. could perform other jobs existing in significant numbers in the national economy and therefore was not disabled during the relevant period.

Medical Opinion Evidence

The court held that the administrative law judge improperly rejected the opinion of treating physician James Kravetz, D.O. Dr. Kravetz opined that Lance P. could lift less than 10 pounds, stand or walk for less than two hours in an eight-hour workday, and sit for less than six hours in an eight-hour workday.

The court found that the administrative law judge did not provide specific and legitimate reasons supported by substantial evidence for rejecting those limitations. The judge relied on treating podiatrist Aderonke Ojo’s treatment and on examining physician Farah M. Rana’s opinion, but Dr. Ojo had not stated how many hours Lance P. could stand, walk, or sit. The court also found that the administrative law judge mischaracterized Dr. Rana’s examination by describing Lance P.’s gait as normal, even though Dr. Rana reported that he walked with a mild limp and complained of left-ankle pain. The court further noted that insurance had denied coverage for some prescribed treatments and that Lance P. could not afford them.

The court upheld the administrative law judge’s treatment of examining psychologist Paul Martin, Ph.D.’s opinion. Dr. Martin identified moderate limitations involving regular attendance, consistent work, completing a normal workday or workweek, and dealing with workplace stress. The court concluded that the administrative law judge gave legally sufficient reasons for discounting those opinions, including contrary opinions from state-agency psychological consultants and essentially unremarkable mental-status findings.

Lance P.’s Testimony and Patricia Roe’s Statement

The court held that the administrative law judge improperly discounted Lance P.’s testimony about the severity of his pain and related limitations. Because the judge found that Lance P.’s impairments could reasonably cause the claimed symptoms and did not find that he was malingering, the judge needed specific, clear, and convincing reasons to reject the testimony. Instead, the judge relied primarily on general statements that the testimony was inconsistent with the medical evidence and the residual functional capacity assessment. The court found those general statements insufficient.

The court also held that the administrative law judge improperly discounted Patricia Roe’s third-party statement. Ms. Roe reported that Lance P. could not stand for more than 10 or 15 minutes because of foot pain, could not walk his dog or hike, and had limitations involving multiple physical and mental activities. The judge gave limited weight to her statements about exertional limitations because she was not a medical source and focused on activities Lance P. could perform independently while ignoring activities he could not perform independently or at all. The court found that this was not a sufficient basis for discounting her statement.

Vocational Evidence

The court rejected Lance P.’s challenge based on outside sources concerning the standing and walking requirements of certain occupations. The court noted, however, that the administrative law judge ignored the vocational expert’s clarification that a person with the stated six-hour standing and walking limitation could not perform two of the three identified jobs. The vocational expert identified other positions, including merchandise marker, router, and order caller, that could be performed with the limitation. Those positions could have supported the denial if the residual functional capacity assessment had been supported by substantial evidence. Because the court found that the residual functional capacity assessment was unsupported, the vocational testimony based on it did not adequately support the denial.

Remedy and Disposition

The court found that the errors concerning Dr. Kravetz’s opinion, Lance P.’s testimony, and Ms. Roe’s statement were not harmless because they affected the step-five finding about whether other work was available. The court determined that the record had been fully developed through two rounds of administrative proceedings and that further proceedings would serve no useful purpose.

The court also concluded that accepting Dr. Kravetz’s limitations would restrict Lance P. to sedentary work. The court stated that, under the cited regulatory grid rule, a person closely approaching advanced age, with limited or less than a high-school education, without transferable skills, and limited to sedentary work would be found disabled. The Commissioner did not argue that Lance P. had transferable skills or that the rule would not apply. The court therefore ordered payment of benefits rather than another administrative hearing.

The order granted Plaintiff’s motion for summary judgment, denied Defendant’s cross-motion for summary judgment, reversed the Commissioner’s decision, and remanded the case for payment of benefits.