P.H. v. Kijakazi

Background

P.H. applied for disability and Supplemental Security Income benefits, alleging disability beginning January 1, 2014. The Social Security Administration previously found her disabled beginning August 28, 2018, but not before that date. The Appeals Council vacated that decision and sent the matter back to the administrative law judge (ALJ) for further consideration, including evaluation of possible intellectual disorder under Listing 12.05, the evidence of P.H.’s limitations, and the reason for the selected onset date.

After a second hearing, the ALJ again found P.H. disabled beginning August 28, 2018, but not earlier. For the earlier period, the ALJ found that P.H. could perform medium work with restrictions to simple tasks, limited changes, and no fast-paced production requirements. At the later onset date, the ALJ found that P.H. would be off task for at least 10 percent of a workday and limited her to light work. Based on vocational-expert testimony and the applicable medical-vocational rules, the ALJ found that P.H. could perform other work before August 28, 2018, but was disabled after that date.

Court’s analysis

The court reviewed the Commissioner’s decision under the substantial-evidence standard. Because P.H.’s claim was filed before March 27, 2017, the court applied the regulations requiring appropriate weight to medical opinions. An ALJ must provide sufficiently strong, evidence-based reasons to reject a contradicted opinion from an examining physician and even stronger reasons to reject an uncontradicted one.

The court held that the ALJ did not provide sufficient reasons for discounting Dr. Lara San Pedro’s 2018 report. Dr. San Pedro performed standardized psychological testing, including an intelligence test and memory and neuropsychological testing. P.H. received extremely low scores on much of that testing, and Dr. San Pedro assessed marked or extreme limitations in several work-related abilities. The court rejected the ALJ’s reliance on P.H.’s lack of mental-health treatment, the asserted reliance on P.H.’s subjective reports, and the fact that Dr. San Pedro was an examining rather than treating psychologist. The ALJ also did not give specific reasons for rejecting the objective test results.

The court likewise held that the ALJ did not adequately evaluate Dr. Paul Martin’s 2019 report. That report included objective testing showing extremely low intellectual and memory scores and significant difficulty with sustained attention and mental tracking. The court found that the ALJ ignored or inadequately addressed those results and did not explain why P.H.’s limited treatment, ability to manage her own funds, or occasional normal observations justified rejecting the broader assessment. The court also held that Listing 12.05 focuses on the effects of an impairment rather than requiring a particular diagnosis of intellectual disorder.

The court further found errors in the ALJ’s treatment of P.H.’s educational history. The ALJ presumed that P.H. graduated from high school based on a small number of records, while overlooking her testimony that she did not graduate or obtain a general educational development certificate and overlooking her transcript. The transcript showed extremely poor academic performance and very little credit during her final two years. The court held that the ALJ’s presumption was not supported by substantial evidence. The court also found that the ALJ did not adequately consider the limited nature of P.H.’s college attendance.

The court held that the ALJ also applied incorrect standards when evaluating P.H.’s daily activities and past work. Simple activities such as personal care, preparing meals, chores, or driving do not automatically disprove intellectual disability. The ALJ did not identify evidence that P.H. performed the cited activities independently, appropriately, effectively, and on a sustained basis, or explain how they transferred to a work setting. The court also explained that past work does not necessarily conflict with Listing 12.05, because the listing requires current marked or extreme limitations while separately requiring evidence that the disorder began before age 22. Regulations do not require proof that the claimant met every listing requirement or the statutory definition of disability before age 22.

The court rejected the Commissioner’s remaining arguments as substantial support for the ALJ’s conclusion. The possibility that substance use contributed to P.H.’s impairments did not itself negate disability, and the ALJ had found that P.H.’s conditions persisted during periods of abstinence. The court also found that the ALJ failed to identify specific statements by P.H. that were discredited and failed to provide the required reasons for rejecting her symptom testimony, although the court did not rely on that error as an independent reason for reversal because P.H. did not identify the specific testimony at issue or explain how crediting it would establish an earlier onset date.

Remedy and disposition

The court declined to order an immediate calculation and payment of benefits under the credit-as-true rule. Although the ALJ had given insufficient reasons for rejecting the 2018 and 2019 reports, those reports did not necessarily establish disability before their examination dates, did not resolve whether the disorder began before age 22, and differed in potentially important respects. Further administrative proceedings therefore remained useful and necessary.

Judge A. J. Cisneros granted P.H.’s motion for summary judgment except as to her request to remand for benefits without further proceedings, denied the Commissioner’s cross-motion for summary judgment, and remanded for further administrative proceedings consistent with the order. The clerk was directed to enter judgment for P.H. and close the case.